HIV/AIDS, tuberculosis (TB) and malaria are preventable and treatable diseases that disproportionately affect the world’s poor. Sub-Saharan Africa is the hardest hit region, accounting for 90% of malaria deaths, more than 70% of all people living with HIV and 26% of all TB cases.
The human impact of these diseases is undeniable, but their socioeconomic impact is also severe. HIV and TB often affect people in their most productive years. Businesses are losing their workers, governments are losing their civil servants and families are losing not only their loved ones but also their breadwinners.
The world has battled malaria and TB for centuries, but the immense human toll of AIDS in the late 1990s injected a new urgency into global prevention and treatment efforts. Though the resources to fight these diseases have increased exponentially throughout most of the 2000s, funding remains insufficient for global disease control. Infectious diseases are particularly challenging, because even once progress has been made against them, they can rebound quickly if global efforts to fight them stagnate or stop.
Weak health systems further complicate the fight against these diseases, especially in sub-Saharan Africa. The shortage of health workers, for example, is a major hurdle in expanding treatment and prevention efforts. Sub-Saharan Africa accounts for 24% of the global burden of disease, but only 3% of the world’s health workforce. Health workers at all levels of delivery, as well as the systems, supplies and facilities that support them, must be strengthened to tackle infectious diseases and to ensure better basic health care and outcomes overall.
New momentum in the fight against HIV/AIDS, TB and malaria has helped millions of people get access to prevention and treatment services. Antiretroviral medication for people living with HIV/AIDS now generally costs $100 per patient per year, down from nearly $10,000 only ten years ago. The four tools for malaria elimination (insecticide-treated bed nets, anti-malarial treatment, indoor residual spraying and preventative treatment for pregnant women) are also extremely affordable. For example, bed nets cost $10 to buy and distribute, while treatment costs $2 or less per dose. TB infection can be prevented and treated as well. In many countries where TB is endemic, $20 on average will buy a full six-month course of treatment to cure TB.
The increase in global resources to fight these three diseases has led to real results. Global malaria deaths have declined by 60% in last 15 years, saving 6.2 million lives (95% which are children). In 2014, 13 countries reported no cases of the disease and six countries reported fewer than 10 cases. Life-saving antiretroviral treatment has meant that an AIDS diagnosis is no longer a death sentence for millions of people. In 2015, over 17 million people around the world were receiving antiretroviral treatment for HIV/AIDS, up from just 770,000 in 2000, 12.1 million of whom lived in sub-Saharan Africa. Meanwhile, global deaths due to AIDS have dropped consistently in that time, down from 2 million in 2004 to 1.1 million in 2015. Thanks to effective diagnosis and treatment of TB, the MDG target to halt and reverse TB incidence has also been achieved on a worldwide basis (in each of the six WHO regions and in 16 of the 22 high-burden countries that collectively account for 80% of TB cases), and 49 million lives have been saved since 2000.
In order to make faster progress on eventually ending these infectious disease pandemics – while also preparing for new and emerging threats, such as Ebola and Zika – we need a continued scale-up of resources from both donors and from high-burden countries’ own domestic funding. We also need a smarter deployment of treatment and prevention strategies, and concerted efforts to strengthen the health systems around these programs.