Global Fund TB Grants in Asia and the Pacific. Swarup Sarkar Director, Asia Pacific CCM Unit ICAPP, 2009, Bali

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1 Global Fund TB Grants in Asia and the Pacific Swarup Sarkar Director, Asia Pacific CCM Unit ICAPP, 2009, Bali

2 Outline GF Financing on TB Progress: case detection rate, cure rate March towards MDG : Incidence Prevalence Death Which factors are triggering progress : Income, health service, Physicians. Health financing, GF grant For well performing countries vs poor performing countries Where are GF items spent? What can be done better?

3 Outline GF Financing on TB Progress: case detection rate, cure rate March towards MDG : Incidence Prevalence Death Which factors are triggering progress : Income, health service, Physicians. Health financing, GF grant For well performing countries vs poor performing countries Where are GF items spent? What can be done better?

4 TB Financing of GF in Asia & the Pacific Board approved grant amount US$ 1.3 B Signed amount US$ 0.8 B Disbursed amount US$ 0.5 B 191 M USD signed in 2009 Source: TGF web page 27July 09

5 Millions (USD) TB Financing of GF in Asia & the Pacific Rounds 1 8, (July 09) South Asia Approved Signed Disbursed East Asia South Asia Source: TGF web page

468 800 600 247 500 400 801 157 200 554 337 0 Approved

6 Global Fund Share of International Financing for TB Loans 18% Grants Excluding GF 25% Global Fund 57% Source: WHO Stop TB Data, 2008

7 % Comitted Funds and DALYS TB Commitments Relative to Burden of Disease in Asia % 9% 80 32% 35% TB 60 36% HIV/AIDS Malaria 40 47% 56% 20 21% 48% 0 Source: TGF web page 27 July 2009 DALYS from WHO, 2008 Committed 21% SEAR WPR DALYS DALYS C o

HIV/AIDS Malaria 40 47% 56% 20 21% 48% 0 Source: TGF web page

8 Millions (USD) Global TB Commitments Rounds 1 8, (June 09) Source: Key Financial Figures Finance Dept. 22 June

0 Source: Key Financial Figures Finance Dept.

9 millions (USD) TB Commitments in East Asia and the Pacific Rounds 1 8, (July 09) million USD committed Source: Key Financial Figures Finance Dept. 16 July 2009

committed 50 0 0 0 2002 2003 2004 2005 2006 2007 2008 2009

10 Outline GF Financing on TB Progress: case detection rate, cure rate March towards MDG : Incidence Prevalence Death Which factors are triggering progress : Income, health service, Physicians. Health financing, GF grant For well performing countries vs poor performing countries Where are GF items spent? What can be done better?

11 Case Detection Rate

12 Case Detection Rate

13 GF Resources

14 Successful Treatment Completion

15 TB Mortality rate

16 Outline GF Financing on TB Progress: case detection rate, cure rate March towards MDG : Incidence Prevalence Death Which factors are triggering progress : Income, health service, Physicians. Health financing, GF grant For well performing countries vs poor performing countries Where are GF items spent? What can be done better?

17 Incidence

18 MDG for incidence

19 Mortality MDG

20 Prevalence MDG

21 Outline GF Financing on TB Progress: case detection rate, cure rate March towards MDG : Incidence Prevalence Death Which factors are triggering progress : Income, health service, Physicians. Health financing, GF grant For well performing countries vs poor performing countries Where are GF items spent? What can be done better?

22 Role of Health Worker?

23 Per Capita Expenditure

24 % GDP spent on health

25 % External / Total Health Expenditure

26 Outline GF Financing on TB Progress: case detection rate, cure rate March towards MDG : Incidence Prevalence Death Which factors are triggering progress : Income, health service, Physicians. Health financing, GF grant For well performing countries vs poor performing countries Where are GF items spent? What can be done better?

27 Results 95? % of patients having sputum positive TB could refer to their illness in chest 72? % of patients having X ray positive TB could refer to illness to their chest >80? % visited some health care services <40? % received treatment for TB

28 Cost Breakdown Other 3% Technical Assistance 2% Living Support to Clients/Target Population 5% Overheads 3% Procurement and Supply Management Costs 1% Health Products and Health Equipment 7% Planning and Administration 6% Training 24% Monitoring and Evaluation 12% Medicines and Pharmaceutical Products 7% Infrastructure and Other Equipment 9% Communication Materials 10% Human Resources 11% Source: EFR 27 July 2009

29 Cost Breakdown 80,000, ,000, ,000, ,000, ,000, ,000, ,000, ,000, Training Monitoring and Evaluation Human Resources Communication Materials Infrastructure and Other Equipment Medicines and Pharmaceutical Products Planning and Administration Health Products and Health Equipment Living Support to Clients/Target Population Other Overheads Technical Assistance Procurement and Supply Management Costs Budget (USD) Expenditure (USD) Source: EFR 27 July 2009

30 In search of ideas for Health System Strengthening. 2015

31 Role of WHO Design Implementation Evaluation Global Fund Grant Life Cycle

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