The Global Fund support for Tuberculosis control STOP TB Symposium 3 December 2009, Cancun Prof. Rifat Atun and Dr Mohamed Aziz.
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The Global Fund support for Tuberculosis control
STOP TB Symposium 3 December 2009, Cancun
Prof. Rifat Atun and Dr Mohamed Aziz
1. Global Fund support for the 3 diseases
2. Global Fund support for Tuberculosis
3. Round 9 for TB
4. Results achieved
5. The way forward
Countries with Global Fund Grants
BG/281108/7
1
2 (new)
3 (new)
4 (new)
5 (new)
6 (new)
7 (new)
8 (new)
0 5,0002,500
Kilometers ´
Regional DistributionRounds 1-8, (July 2009)
100% = US$ 15.9 billionPercentages of total funds approved by the Board, including Phase 2 & RCC
Global Fund Grant Resources by Region
OP/140709/2
Eastern Europe & Central Asia
7%
Middle East & North Affrica
6%
Latin America & the Caribbean
7%
East Asia & Pacific14%
Sub-Saharan Africa58%
South Asia8%
Country Classification: by Income levelRounds 1-8, (July 2009)
100% =US$ 15.9 billionPercentages of total funds approved by the Board, including Phase 2 & RCC
Global Fund Grant Resources by Income Level
OP/140709/1
Upper Middle
10%
Lower Middle
34%
Low 56%
Administration7%
Human Resources
21%
Commodities, Products, Drugs
45%
Monitoring and Evaluation
4%
Infrastructure and Equipment
9%
Other14%
How are Grant Funds Used?
Resources by Expenditure Component
OP/140108/6
1. Global Fund support for the 3 diseases
2. Global Fund support for Tuberculosis
3. Round 9 for TB
4. Results achieved
5. The way forward
Rounds 5-9: success rates by disease area
0%
10%
20%
30%
40%
50%
60%
70%
80%
Round 5 Round 6 Round 7 Round 8 Round 9
HIV
Tuberculosis
Malaria
Overall
TB success rates (excluding HSS parts)
RoundsEligible
proposalsRecommended
proposalsSuccess rate
Round 9 & NSAs
56 34 61%
Round 9 54 32 59%
Round 8 57 29 51%
Round 7 41 19 46%
Round 6 55 34 62%
Total Phase 1 funding approved: US$2.1 billion
Disease Components DistributionRounds 1-8, (July 2009)
Global Fund Resources by Disease Component
100% = US$ 15.9 billion Percentages of total funds approved by the Board, including Phase 2 & RCC
OP/140709/3
Malaria29%
HIV/AIDS57%
TB14%
Global Fund Contribution to International Financing for Tuberculosis, 2008
Global Fund provided 57% of all international funding in 2008
Source: WHO Stop TB data, 2008
SE/260309/4
Global Fund57%
Grants (excluding
Global Fund)25%
Loans18%
Tuberculosis CoverageAfter 8 Rounds of proposals
110 countries
184 components
US$ 1.2 billion (2 years)
US$ 3.1 billion (5 years)
BG/281108/9
0 5,0002,500
Kilometers ´
1. Global Fund support for the 3 diseases
2. Global Fund support for Tuberculosis
3. Round 9 for TB
4. Results achieved
5. The way forward
Round 9 and NSA Funding Recommendations
• Phase 1 upper-ceiling amounts recommended by the TRP for Round 9 and the First Learning Wave of National Strategy Applications (NSA) and AMFm:
Round 9 US $ 2.2 billionNSA FLW US $ 434 million
• Total Round 9 and NSA FLW recommended for funding: US $ 2.6 billion (Phase 1) and US $ 7.2 (Lifetime budget) (Board decision: 20th Board Meeting)
Round 9 and NSA Funding Recommendations
• Round 9 overall success rate: 53% (85 of 159) (includes HSS s4B/5B)
• NSA overall success rate: 71% (5 of 7)
• 2 new single country beneficiaries recommended: Mexico and Turkmenistan
Round 9 - Number of proposals recommended and success rates
74
54
31
159
30 3217
79
HIV Tuberculosis Malaria Overall
Review ed Recommended
Success rate 41% 59% 55% 50%
Round 9 success rates (excluding HSS s4B/5B)
Round 9: Disease parts by TRP recommendation category and by disease
39
18 1370
9
17
4
30
19 14
11
44
54 1 10
5212
HIV Tuberculosis Malaria Overall
Category 1
Category 2
Category 2B
Category 3
Category 4
41%
59% 55%
50%
Recommendedfor funding
Round 9 TB funding recommendations: by region
Recommended TB proposals, per WHO region
AFRO11
EMRO3
EURO8
WPRO2SEARO
2
AMRO6
NSA - Number of proposals recommended and success rates
3
2 2
7
1
2 2
5
HIV TB Malaria Overall
Reviewed
Recommended
Success rate 33% 100% 100% 71%
Round 9: HSS cross-cutting requests
23
74
34
12
3 2
17
HIV cc. HSS
Tuberculosiscc.HSS
Malaria cc. HSS
Overall cc. HSS
Review ed Recommended
Round 9 Success rate 52% 43% 50% 50%
Round 8 Success rate 56% 50% 50% 53%
1. Global Fund support for the 3 diseases
2. Global Fund support for Tuberculosis
3. Round 9 for TB
4. Results achieved
5. The way forward
TB financing and cumulative new sputum positive cases detected and treated, by year
How Do Results Scale-up?June 2009
GP/110608/9
0.0
1.0
2.0
3.0
4.0
5.0
6.0
2004 2005 2006 2007 2008 Mid-2009
ARV
and
DO
TS (m
illio
ns)
0
10
20
30
40
50
60
70
80
90
ITN
(mill
ions
)
DOTS
ARVITNs
Average grant performance (results vs. grant targets) over time
102%
84%
95%
45%
55%
65%
75%
85%
95%
105%
1 2 3 4 >4
Grant age (years)
Gra
nt
pe
rfo
rma
nc
e
HIV
Malaria
TB
Performance: results vs. agreed-upon, time-bound targets
Achievement
• To date, The GF approved treatment of 46 000 MDR cases
• Yet less than half of the cases are treated through the GLC mechanism
• With Round 9 grant life the total MDR supported with GF funding will reach 100 000 patients
1. Global Fund support for the 3 diseases
2. Global Fund support for Tuberculosis
3. Round 9 for TB
4. Results achieved
5. The way forward
1. Universal access to high quality TB control measures.
2. Better targeted TB proposals which will increase success rate
3. Increased emphasis on TB/HIV collaborative activities
• Round 9 – not all TB proposals did include HIV activities and vice versa
• Better communication from The Global Fund and Technical Organisations
4. Increased demonstration of cost-effectiveness of tuberculosis prevalence surveys in proposals as recommended by TRP in Round 9
5. Repackaging TB messages to make it more positive and increase the focus on achievements and success stories.
6. Urgent need to scale up MDR treatment.
7. Inclusion of infection control measures.
8. Better demonstration of HSS support in TB proposals.
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