The Global Fund support for Tuberculosis control STOP TB Symposium 3 December 2009, Cancun Prof. Rifat Atun and Dr Mohamed Aziz.

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.