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Global Health

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The Reality

Infectious Diseases Expenditures

Infectious diseases are responsible for millions of deaths each year, primarily in developing countries.1, 2 3 Infectious diseases also disable millions of children and adults, reducing quality of life and creating financial hardships for families. Tuberculosis (TB) has re-emerged as a global and increasingly drug-resistant threat. In Africa, malaria is the leading killer of children and, among adults, lost productivity due to illness is estimated to reduce gross domestic product growth by 1.3 percent per year.4 Readily neglected diseases, including intestinal worms, render children and adults weak and malnourished.5 Increased funding will facilitate a scale-up of interventions that improve quality of life and prevent millions of deaths.

Global Expenditures Global funding for TB and malaria has increased in recent years through disease-specific funding mechanisms, especially the Global Fund to Fight AIDS, TB and Malaria (The Global Fund).6 Neglected diseases have also received an increase in funding.7 Yet the remaining gap between needs and available funds prevents large-scale implementation of simple solutions. » The Global Fund is the largest source of external funding for anti-TB and malaria programs, providing about twothirds of global spending for each disease.6

» Since its first year of funding, the U.S. President’s Malaria Initiative has increased resources from $30 million in 2006 to $500 million in 2010.8 » In the third year of the Initiative, 32 million individuals have benefited from prevention or treatment services in the 15 focus countries.8

Billions of USD

» Since its creation in 2002, the Global Fund has enabled 4.6 million Estimated Infectious Disease Funding Needs people to be treated for TB and 5.3 million to be treated with for 10 malaria. Additionally, 46 million insecticide-treated bednets have been 9 distributed with their funds. 8 7 6 5 4

Neglected Diseases Malaria Tuberculosis

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» Foundations and public-private partnerships have played an increas0 ingly important funding role. 2008 2009 2010 • Pharmaceutical companies have partnered with governments and NGOs to provide drugs and materials at no or low cost, particularly for neglected diseases in the most resourcescarce countries.9 • To date, the Bill and Melinda Gates Foundation has committed more than $3 billion in grants, to combat infectious diseases, including many neglected diseases, in addition to millions more in funding for TB. The Foundation provides major support for vaccine research for malaria and other diseases. It has pledged to triple its funding for TB by 2015.10 » TB: In 2009, $4.2 billion was needed to fully implement TB programs in 94 of the most affected countries; however only $3 billion was available worldwide.11Affected country governments and citizens provided the major share of funds (87%) while 9 percent came from the Global Fund and 4 percent from other sources. 11 » Malaria: While funding resources for malaria have increased dramatically from the $0.3 billion levels in 2003, there still exists gaps in funding.12 Funding levels in 2009 reached $1.5 billion-in large part due to commitments made by the Global Fund, the US’s President’s Malaria Initiative, the World Bank and others-however funding still fell short of the $3.1–$3.4 billion needed.12-14 Governments and other domestic sources, including citizens, spend about $300 million per year. » Neglected diseases: Total resources needed to fight 13 neglected diseases affecting 1 billion people are $2.8-$4 billion over five years.9 A package of seven drugs that treats five different neglected diseases costs 50 cents per person for drugs, delivery, equipment, human resources, and monitoring and evaluation.9


Current U.S. Expenditures

 In FY 2010, the appropriation for infectious diseases was distributed as follows:15 • $585 million for malaria • $225million for TB • $ 65 million for neglected diseases • $106 million for global pandemic response (including avian influenza and H1N1)

Infectious Disease Appropriations FY00-FY10, excluding HIV/AIDS Unadjusted USD

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Congress began to appropriate funds targeting infectious diseases through USAID in 1996. The U.S. has become a global leader in funding infectious disease programs, especially to combat HIV and malaria.7 Non-HIV funding has increased from $55 million in 1998 to nearly $1 billion ($981 million) in FY10.









 





















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 The President’s Malaria Initiative, initiated in 2005, focuses on expanding prevention and treatment programs in sub-Saharan Africa. The goal is to provide $1.2 billion over five years.16

Infectious Disease Appropriations FY99-FY10, excluding HIV/AIDS 7XEHUFXORVLV

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Âť In 2008, President Bush announced a new Global Initiative to Combat Neglected Tropical Diseases, which would provide $350 million over five years beginning in 2009.17 Since that time, funding for NTDs has increased three-fold.15



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Âť Funding for TB increased by 47 percent from 2008 to 2010 to address the emerging threat of drug-resistant TB.7, 15









 























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A Call to Action The Global Health Council calls for the global community to significantly increase its commitment to reducing the global burden of infectious disease through increased resources and science-based, comprehensive interventions as well as monitoring and evaluation of programs and investments. This includes continued support of bilateral and multilateral infectious disease programs with equitable investments from the U.S government, other donors and endemic countries to meet the global funding gap. Updated January 2010 1. World Health Organization. WHO global burden of disease (GBD) 2004 estimates; 2008. 2. Breman J, Alilio M, Mills A. Conquering the intolerable burden of malaria: whatâ&#x20AC;&#x2122;s new, whatâ&#x20AC;&#x2122;s needed American Journal of Tropical Medicine & Hygiene 2004;71:1-15. 3. UNAIDS. 2009 AIDS Epidemic Update. Geneva: UNAIDS; 2009. 4. Malaria Foundation International. The Abuja Declaration on Roll Back Malaria in Africa by the African Heads of State and Government. In: April 25, 2000. 5. Hotez PJ MD, Fenwick A et al. Incorporating a rapid-impact package for neglected tropical diseases with programs for HIV/AIDS, tuberculosis, and malaria. PLoS Medicine 2007;3(No 5 e102). 6. Friends of the Global Fight. Fact sheet. The Global Fund to Fight AIDS, Tuberculosis and Malaria; 2008. 7. Global Health Council. U.S. investments in global health; 2008. 8. Presidentâ&#x20AC;&#x2122;s Malaria Initiative. Fast Facts: The Presidentâ&#x20AC;&#x2122;s Malaria Initiative In: Initiative PsM, editor. Washington, DC; 2009. 9. Global Network for Neglected Tropical Disease Control. Control of NTDs. In. 10. Bill & Melinda Gates Foundation. Global health program; 2006. 11. World Health Organization. Global tuberculosis control: epidemiology, strategy, financing; 2009. 12. World Health Organization. 2009 World Malaria Report. Geneva; 2009. 13. Teklehaimanot A, et al, Scaling up malaria control in Africa: an economic and epidemiological assessment. Am J Trop Med Hyg 2007;77(Suppl 6):138-144. 14. Global Fund. Resource needs for the Global Fund 2008-2010; 2007. 15. US House of Representatives. State, Foreign Operations & Related Programs - House Rept. 111-366 FY 2010 Consolidated Appropriations Act (HR 3288). In; 2009. 16. Presidentâ&#x20AC;&#x2122;s Malaria Initiative. Overview. 17. White House Office of Communications. Press release:; 2008.


Infectious Diseases Expenditures