Backgrounder No 1
HIV, TB AND MALARIA THREE
MAJOR INFECTIOUS DISEASES THREATS
Background for the G8 discussions
Infectious diseases are the leading killer of young people in
- Infectious diseases are responsible for almost half of mortality in developing
countries. These deaths occur primarily among the poorest people because they do not have
access to the drugs and commodities necessary for prevention or cure. Approximately half
of infectious disease mortality can be attributed to just three diseases HIV, TB
and malaria. These three diseases cause over 300 million illnesses and more than 5 million
deaths each year.
- None of these diseases has an effective vaccine to prevent infection in children and
New information shows that their economic and social burden is
- In addition to suffering and death, these diseases penalize poor communities, as they
perpetuate poverty through work loss, school drop-out, decreased financial investment and
increased social instability creating sizeable social and economic costs.
- For example, Africa's GDP would be up to $100 billion greater if malaria had been
eliminated years ago.
- A nation can expect a decline in GDP of 1% per year when more than 20% of the adult
population is infected with HIV.
- Increasingly, infectious diseases are moving across borders. Over half of TB cases in
some wealthy countries are among foreign-born populations. Over 12,000 cases of malaria
were reported among European travellers last year.
Infectious diseases are a matter of national security:
- Sustainable development is feasible if countries can tame the infectious diseases that
disempower their people. If these diseases continue unchecked, they damage the social
fabric; diminish agricultural and industrial production; undermine political, social and
economic stability; and contribute to regional and global insecurity.
We have affordable and highly effective solutions available now:
- Each of these three diseases can be prevented or treated for between $.05 and $10.
- Many low income countries have shown that, by using available tools both widely and
wisely, TB deaths can be reduced five-fold, HIV infection rates can also be reduced by 80%
and malaria death rates can be halved.
- But, when a country has a healthcare budget of less than, for example, $50 per capita,
the costs of the tools needed to fight TB, malaria and HIV are prohibitive. Many of the
world's poor people live in countries with very low budgets for health care.
We need concerted action to use existing tools more effectively - i.e.,
both widely and wisely
We need a new mechanism to take proven interventions to scale. This
mechanism would achieve internationally agreed targets to cut TB and malaria mortality by
50%, and HIV infection by 25%. It would lead to concerted action that:
- Enhances access to effective health care within the homes of those who are vulnerable to
infection. Greater impact could be achieved through mass education, making mosquito
nets widely available, ensuring access to condoms, and enabling people to use other
essential health commodities.
- Uses novel methods to ensure quality of health services whether provided through the
private, NGO or public sectors: the use of a range of delivery organisations will
increase the potential to getting to all those in need:
- Offers an integration of five primary functions -- advocacy for health
action, financing of health care, procurement of essential commodities, delivery of
services and monitoring results -- for a seamless, efficient pipeline. This would lead to
global catalysis of standardised and effective services, that are properly co-ordinated,
and provided in an efficient manner - without duplication of effort.
- Ensures that when funds are allocated, preference is given to groups well able to
deliver effective services, backed up by rigorous surveillance and monitoring routines
to document the health gains that result from financial investments.
And there needs to be more development assistance
- The total spent on HIV prevention in sub-Saharan Africa (excluding South Africa) last
year was $165 million from all sources. Current estimates now suggest that sums in the
order of $ 2.5 billion are needed for prevention alone. Add the costs of care, and the
figure rises dramatically.
- In malaria a similar picture: it is estimated that $1 billion a year is required to make
a real difference. But the pay-off could be as much as $3-12 billion a year in terms of a
boost to the combined GDP of countries in sub-Saharan Africa.
- In the case of TB, $1 billion spent on drugs could mean that 70% of new cases could be
treated, resulting in a 50% reduction in mortality over the next 5 years.
The World Health Organization (WHO) is proposing a new framework for
concerted action a massive effort to tackle the infectious diseases which sustain
- Within developing nations, new mechanisms are coming into place to stimulate effective
action against infectious diseases through public services, and supplemented where
necessary through private channels:
- financial support will reward the achievement of better health outcomes;
- management systems will be accountable to national governments, in ways that are
responsive to the interests of people and give communities more control;
- focused partnerships will bring together public, private and voluntary organisations to
provide services of consistent quality;
- social marketing will get subsidised goods to those who need them through private
- service quality will be sustained through tightly managed franchises;
- such innovation, increasingly supported by Heads of State of developing countries, and
their governments, will increase access to effective technologies;
- countries will be able to achieve the health outcomes they have desired for all their
- At a global level, WHO has established incentives to stimulate research and development
into new technologies particularly vaccines and cost-effective drugs. WHO is
working for international regulatory and legal systems which balance the need to protect
intellectual property and the need to ensure more equitable access to essential medicines.
WHO will transform the ways in which the UN agencies work with governments, establishing
new high performance efforts that get effective interventions directly to poor people.
- WHO will take advantage of means commonly used by the private sector for economies of
scale in the procurement and distribution of key health care commodities and services.
- WHO is changing its tactics in the battle against communicable disease. Working with
Heads of State and their governments, WHO is concentrating on getting essential goods and
services directly to those in need. Working with those who can provide resources, WHO is
offering mechanisms that link the funds invested directly to the results achieved. Working
with those who market products, deliver services and monitor achievement, WHO is rewarding
- WHO will ensure that the international system is well able to handle additional
financial commitments, service innovative partnerships, and sustain efficient ways of
working. The reward is clear - better health is key not just to reducing
peoples' poverty and increasing national prosperity, but also to global stability
and, for everyone, greater peace of mind.
For further information, journalists can contact :
WHO Press Spokesperson and Coordinator, Spokesperson's Office,
WHO HQ, Geneva, Switzerland / Tel +41 22 791
4458/2599 / Fax +41 22 791 4858 / e-Mail: firstname.lastname@example.org