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Successes in Global Health: progress in the fight against disease

April 2, 2011

Some of the most striking signs of progress include:

  • Major declines in child mortality: The number of children who die before age five has been halved since 1960—from 20 million to less than 9 million per year in 2009—even as the number of births increased by more than 20 percent. The death rate declined by more than a quarter (27 percent) from 1990 to 2007 alone.1, 2
  • Increasing life expectancy: The United Nations Population Division estimates that if recent progress against HIV/AIDS and other infectious diseases continues, life expectancy in the world’s poorest countries will increase from 56 years today to 69 years in 2050.3

These advances are just the beginning. New knowledge and tools are making it possible to accelerate progress against a wide range of diseases that disproportionately affect the world’s poor. A growing number of success stories illustrate the potential to continue improving health through financial commitment and leadership from both developed and developing countries.

Other recent successes in global health include:

Childhood immunization:

  • Since its founding in 2000, the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunization) —a global partnership that funds expanded immunization for children in poor countries—has helped prevent an estimated
    5.4 million deaths.4
  • Aggressive measles immunization campaigns are saving children’s lives in poor countries at a cost of about $1 (U.S.) per child.5
  • Thanks to these efforts, the number of people who died of measles worldwide fell by 78 percent between 2000 and 2008. Much of the decline is due to progress in Africa, where measles deaths fell by 89 percent.6

Polio:

  • After two decades of remarkable progress, the world now has the opportunity to eradicate polio. In 1988, more than 1,000 children became sick with polio each day. As a result of polio immunization campaigns, that number dropped to fewer than three per day by 2009—a decline of 99 percent in just 20 years.7
  • Between 1988 and 2008, global eradication efforts averted some 250,000 deaths from polio and protected more than 5 million people who would otherwise have been paralyzed and incapacitated by the disease.8
  •  Donors and countries hard-hit by polio are now making a renewed push to complete the final, difficult stages of polio eradication, with new financial resources, more effective vaccines, and stronger political commitments in the countries that remain most affected.

Malaria:

  • The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) has brought urgently needed new resources to the fight against malaria. Its support has helped deliver 122 million insecticide-treated bed nets—which can help significantly reduce malaria transmission at a total cost of about $10 (U.S.) per net—as well as 108 million malaria drug treatments.9
  • The United States President’s Malaria Initiative (PMI), has distributed over 40 million treatments for malaria since 2006. In 2009 alone, 26 million people were also protected from malaria through indoor residual spraying. 10
  • Renewed attention and resources have had a significant im- pact on the burden of malaria. Since 2000, reported malaria cases have declined by at least half in 38 countries around the world.11

HIV/AIDS:

  • The U.S. President’s Emergency Plan for AIDS Relief (PEP- FAR) has helped rapidly expand HIV prevention and treat- ment programs in poor countries, and is estimated to have saved 1.2 million lives over the last five years.12
  • PEPFAR estimates that by providing HIV prevention services for 16 million pregnant women, it has enabled 240,000 infants to be born free from HIV infection.13
  • The combined efforts of PEPFAR and the Global Fund have dramatically increased access to HIV treatment in low- and middle-income countries. PEPFAR estimates that the num- ber of people receiving life saving anti-retroviral treatment (ART) through these two programs increased more than twelvefold in just four years—from 240,000 in 2004 to nearly 3 million in 2008.14 Globally, more than 5.25 million people are now receiving ART for HIV/AIDS.15
  • In Sub-Saharan Africa, the region hardest hit by HIV/AIDS, the number of people receiving ART (from all funding sources) grew from 100,000 in 2003 to 3.9 million in 2009, according to WHO.15
  • Globally, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that the number of annual AIDS-related deaths recently declined for the first time ever, from 2.2 million in 2005 to 2 million in 2008, largely due to expanded access to ART.16

Tuberculosis:

  • With renewed attention to the global threat of tuberculosis (TB) in recent years, the world is making progress against this long-neglected disease. Following increases throughout the 1990s, WHO reports that TB death rates are now declining in every region of the world, and deaths declined from 1.8 million in 2007 to 1.3 million in 2008. 17
  • By mid-2010, programs supported by the Global Fund were estimated to have detected and treated 7 million cases of TB worldwide—a 30 percent increase in the last year alone.18

Nutrition:

  • The Global Alliance for Improved Nutrition (GAIN), a public-private alliance focused on ending malnutrition, is improving health by partnering with the food industry to fortify staple foods—from wheat flour to soy sauce—with essential micronutrients.
  • GAIN is currently improving nutrition for an estimated 273 million people in more than 25 countries.19
  • Overall, efforts to improve nutrition have made steady prog- ress. Between 1990 and 2005, the proportion of children worldwide under age five who suffered from undernutri- tion declined from 27 percent to 20 percent, according to WHO.20

Neglected tropical diseases:

  • The campaign to eradicate guinea worm—a painful and debilitating parasitic disease—is one of the greatest success stories in global health. Thanks in large part to the leader- ship of the Carter Center, guinea worm cases fell from almost 3.5 million per year in the 1980s to around 3,000 in 2009.21
  • A global effort to eliminate river blindness, led by public- private partnerships in Africa and Latin America, has delivered more than 100 million treatments for this historically neglected disease.22

Notes +

  1. United Nations Population Division. http://esa.un.org/unpp/. Accessed April 2009; and D. You, T. Wardlaw, P. Salama, and G. Jones. Levels and trends in under-5 mortality, 1990-2008. Lancet. Published online September 10, 2009. http://www.thelancet.com/journals/lancet/article/ PIIS0140-6736(09)61601-9/fulltext.
  2. World Health Organization (WHO), World Health Statistics 2009, May 2009, http://www.who.int/ whosis/whostat/EN_WHS09_Full.pdf.
  3. United Nations Population Division, World Population Prospects Population Database: The 2008 Revision, http://esa.un.org/unpp/ (accessed March 2009).
  4.  GAVI Alliance, Impact, value and effectiveness, 2010.
  5.  Measles Initiative, http://www.measlesinitiative.org/ (accessed April 2009).
  6.  WHO, “Progress in Global Measles Control and Mortality Reduction, 2000–2007,” Weekly Epidemiological Record, 5 December 2008, http://who.int/wer/2008/wer8349.pdf.
  7. WHO, Fact Sheet 114: Poliomyelitis, January 2008, http://www.who.int/mediacentre/factsheets/ fs114/en/index.html; and Global Polio Eradication Initiative, Wild Poliovirus Weekly Update, Data as of 21 April 2009, http://www.polioeradication.org/casecount.asp.
  8. Global Polio Eradication Initiative, Budgetary Implications of the GPEI Strategic Plan: Financial Resource Requirements, 2009–2013, January 2009, http://www.polioeradication.org/content/ general/FinalFRR_English2009-2013_January09.pdf
  9. Global Fund press release, July 2010, http://www.theglobalfund.org/en/ pressreleases/?pr=pr_100608; Global Fund, The Global Fund 2010 Innovation and Impact, 2010.
  10. President’s Malaria Initiative, PMI Results, 2010, http://www.fightingmalaria.gov/about/results.html.
  11. WHO, World Malaria Report 2009, December 2009, http://www.who.int/malaria/world_malaria_report_2009/en/index.html.
    declining in every region of the world, and deaths declined from 1.8 million in 2007 to 1.3 million in 2008.
  12. E. Bendavid and J. Bhattacharya, “The President’s Emergency Plan for AIDS Relief in Africa: An Evaluation of Outcomes,” Annals of Internal Medicine, 19 May 2009, http://www.annals.org/cgi/ content/full/0000605-200905190-00117v1.
  13. PEPFAR, Prevention of Mother-to-Child Transmission Fact Sheet, January 2009, http://www.pepfar. gov/documents/organization/114198.pdf.
  14. PEPFAR, Fifth Annual Report to Congress, March 2009, http://www.pepfar.gov/documents/ organization/113827.pdf; and PEPFAR, First Annual Report to Congress, March 2005, http://www. state.gov/documents/organization/43885.pdf.
  15. WHO, Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector, Progress Report 2010, September 2010, http://www.who.int/hiv/pub/2010progressreport/report/ en/index.html.
  16. The Joint United Nations Programme on HIV/AIDS (UNAIDS), Report on the Global HIV/ AIDS Epidemic 2008, August 2008, http://www.unaids.org/en/KnowledgeCentre/HIVData/ GlobalReport/2008/2008_Global_report.asp.
  17. WHO, Global Tuberculosis Control 2009: Epidemiology, Strategy, Financing, March 2009, http:// www.who.int/tb/publications/global_report/2009/en/index.html.
  18. Global Fund press release, July 2010, http://www.theglobalfund.org/en/ pressreleases/?pr=pr_100608.
  19. Global Alliance for Improved Nutrition (GAIN), http://www.gainhealth.org/about-gain, 2010.
  20. WHO, World Health Statistics 2009, May 2009, http://www.who.int/whosis/whostat/EN_WHS09_Full.pdf.
  21.  Carter Center, http://www.cartercenter.org/health/guinea_worm/mini_site/current.html, 2010.
  22.  Carter Center, 2008 River Blindness Report, August 2008, http://www.cartercenter.org/resources/ pdfs/news/health_publications/river_blindness/rb_programsummary07_lions_tcc.pdf.

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