Lives saved by Global Fund-supported HIV/AIDS, tuberculosis and malaria programs: estimation approach and results between 2003 and end-2007
1 The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin Blandonnet 8, 1214 Vernier, Geneva, Switzerland
2 World Health Organization, Stop TB Department, Geneva, Switzerland
3 Program for Appropriate Technology in Health, MACEPA, Ferney-Voltaire, France
4 President's Malaria Initiative, USAID, Washington DC, USA
5 Joint United Nations Program on HIV/AIDS, Policy, Evidence and Partnerships Department, Geneva, Switzerland
6 World Health Organization, HIV/AIDS Department, Geneva, Switzerland
7 Health Metric Network Secretariat, Geneva, Switzerland
8 Joint United Nations Program on HIV/AIDS, China country office, Beijing, China
BMC Infectious Diseases 2010, 10:109 doi:10.1186/1471-2334-10-109Published: 30 April 2010
Since 2003, the Global Fund has supported the scale-up of HIV/AIDS, tuberculosis and malaria control in low- and middle-income countries. This paper presents and discusses a methodology for estimating the lives saved through selected service deliveries reported to the Global Fund.
Global Fund-supported programs reported, by end-2007, 1.4 million HIV-infected persons on antiretroviral treatment (ARV), 3.3 million new smear-positive tuberculosis cases detected in DOTS (directly observed TB treatment, short course) programs, and 46 million insecticide-treated mosquito nets (ITNs) delivered. We estimated the corresponding lives saved using adaptations of existing epidemiological estimation models.
By end-2007, an estimated 681,000 lives (95% uncertainty range 619,000-774,000) were saved and 1,097,000 (993,000-1,249,000) life-years gained by ARV. DOTS treatment would have saved 1.63 million lives (1.09 - 2.17 million) when compared against no treatment, or 408,000 lives (265,000-551,000) when compared against non-DOTS treatment. ITN distributions in countries with stable endemic falciparum malaria were estimated to have achieved protection from malaria for 26 million of child-years at risk cumulatively, resulting in 130,000 (27,000-232,000) under-5 deaths prevented.
These results illustrate the scale of mortality effects that supported programs may have achieved in recent years, despite margins of uncertainty and covering only selected intervention components. Evidence-based evaluation of disease impact of the programs supported by the Global Fund with international and in-country partners must be strengthened using population-level data on intervention coverage and demographic outcomes, information on quality of services, and trends in disease burdens recorded in national health information systems.