RESUMO
The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) has become an increasingly active and influential organization in global health during the past two decades. It is now playing an increasingly important role in the prevention and control of major infectious diseases, international financing for health, public procurement market development across the world. The article outlines the basic architecture of the Global Fund, including its overall information, financing mechanism, operational models and key experiences accumulated. Based on previous cooperation, the article analyzes the importance of the long-term partnership between China and the Global Fund, and proposes policy suggestions to achieve more win-win outcomes in the near future.
RESUMO
Abstract Introduction Needle and syringe programs (NSP) reduce syringe sharing and HIV transmission among people who inject drugs (PWID). However, their effectiveness relies on sufficient individual and population level coverage. In Tijuana, Mexico, the Global Fund (GF) supported NSP during 10/2011-12/2013, but withdrew funds at the end of 2013 following Mexico's re-classification as an upper-middle income country. Objective We tested the hypothesis of higher NSP access and lower receptive syringe sharing among PWID in Tijuana during the GF support period compared to pre-GF initiation and post-GF withdrawal. Method We used data from an ongoing cohort study of PWID in Tijuana (03/2011-10/2015) to implement a segmented regression analysis investigating changes in the self-reported probability of NSP access, reported difficulty in finding sterile syringes and receptive syringe sharing before GF initiation and after GF discontinuation. Results We found a large significant increase in the probability of NSP access (+.07) and decrease in receptive syringe sharing (-.23) right after GF initiation, which continued over the GF period. Subsequently, we found a significant decline in NSP access (-.05) and an increase in receptive syringe sharing (+.02) right after post-GF withdrawal, which continued thereafter. Discussion and conclusion We demonstrated significant temporal changes in NSP access and receptive syringe sharing among PWID in Tijuana after GF initiation and withdrawal consistent with our hypothesis. Coordinated efforts with local authorities are needed to sustain major coverage NSP in settings receiving GF or external aid to guarantee continuity of harm reduction services and prevent reinside in risk behaviors associated with HIV transmission.
Resumen Antecedentes Los programas de intercambio de jeringas (PIJ) reducen la transmisión del VIH entre las personas que se inyectan drogas (PID). Sin embargo, su efectividad depende de una cobertura suficiente a nivel individual y poblacional. En Tijuana, México, el Fondo Mundial (FM) apoyó los PIJ durante 10/2011-12/2013, pero retiró los fondos a fines de 2013. Objetivo Probamos la hipótesis de un mayor acceso a los PIJ y un menor uso receptivo de jeringas compartidas entre las PID en Tijuana durante el período de financiamiento del FM en comparación con el periodo anterior y posterior al FM. Método Usando datos de un estudio de cohorte de PID en Tijuana (03/2011-10/2015), implementamos un análisis de regresión segmentado para investigar cambios en la probabilidad de acceso a las PIJ, la dificultad para encontrar jeringas estériles y el uso receptivo de jeringas compartidas sobre los periodos pre-, durante y post-FM. Resultados Identificamos un aumento en la probabilidad de acceso a PIJ (+.07) y una disminución en el uso de jeringas compartidas (-.23) justo después del inicio del FM, ambos significativos, que se sostuvieron durante el período del FM. Después del retiro del FM, identificamos una disminución en el acceso a PIJ (-.05) y un aumento en el uso de jeringas compartidas (+.02), ambos también significativos. Discusión y conclusión Esfuerzos coordinados con las autoridades locales son necesarios para garantizar una mayor cobertura de los programas de reducción del daño, independientemente de financiamientos externos, para prevenir reincidir en las conductas de riesgo para el VIH en PID.
RESUMO
Objective@#To analyze the performance of the 5 Global Fund Malaria Programmes in China from 2003 to 2013.@*Methods@#All of the proposals, summaries, progress reports, survey reports, Monitoring& Evaluation reports, and performance rating reports of the 5 Global Fund Malaria Programmes in China and the epidemic data of program areas were collected for statistical analysis from 2012 to 2014. Symposiums were held with relevant experts from national and provincial Centers for Disease Control and Prevention, program managers and staffs from national and provincial Global Fund Malaria Programme offices. The completion of the relevant programme indicators (including the general grant information such as program areas, beneficiaries and funding; the implementation of malaria control measures; the performance of malaria control measures; the malaria incidence in the program areas; the prevalence of malaria parasites; and program management and performance evaluation) were analyzed, and the@*results@#of the symposiums were summarized. Results The implementation period of the 5 Global Fund Malaria Programs were as follows: Round 1 from 2003 to 2008, Round 5 from 2006 to 2010, Round 6 from 2007 to 2012, Round 10 from 2012 to 2013, and National Strategy Application (NSA) from 2010 to 2012. Under the support of all the Global Fund Malaria Programs, a total of 11 936 726 fever cases received microscopic tests, 1 485 915 confirmed and suspected malaria cases were treated, 1 579 773 Long Lasting Insecticide-treated Nets were distributed, 3 414 633 regular nets were treated by insecticide, 40 298 284 primary and middle school students received health education on malaria control. Compared with the baseline value, the completion rates of each indicator increased after the implementation of the programs. The growth value ranged from 12.83% to 83.11%, among which the biggest growth was the value of the indicator'Percentage of households with at least one LLIN/ITN in target areas’, and it increased from 9.2% (baseline value of 2006) to 92.31% (value of 2012). The malaria incidence in program areas has dropped significantly year by year, the annual reported malaria incidence in Yunnan and Hainan provinces decreased from 1 950/100 000, 3 850/100 000 in 2002 to 3.31/100 000, 0.15/100 000 in 2012, the P. falciparum malaria incidence in target counties in Hainan province decreased from 90.6/100 000 in 2002 to 0/100 000 in 2012. As from the implementation of NSA grant in 2010 to 2012, the annual reported malaria incidence in 92% of the 75 Type 1 counties was less than 1 per 10 000, 60.00% of Type 1 counties and 98.69% of the 687 Type 2 counties reported zero locally transmitted malaria cases. The Global Fund Secretariat had conducted a total of 37 performance evaluations, of which 9 have been rated as A1, 4 rated as A2, 19 rated as B1 and 5 rated as B1.@*Conclusions@#The Global Fund Malaria Program in China has been closely integrated with the goal and task of National Malaria Control Program, reducing malaria burden in target areas, and pushing Chinese malaria control efforts to move from control to elimination.
RESUMO
The International Foundations have invested large sums of funds to participate in global health gov-ernance and greatly contributed to the promotion of global health. The foundations have extensive experience in the management of global health projects. Based on the nature of the foundation and its structure in the government, this paper compares the management methods of project management, project selection, project planning, project imple-mentation, project follow-up, project evaluation and project completion in two stages of the Gates Foundation and Global Fund. It summarizes the project management features, provided references for China participating in global health governance.
RESUMO
Objective] To analyze the implementation effect of the Global Fund for tuberculosis ( TB) control project on designated hospital , and provide basis and recommendation for TB control in Wenzhou City of Zhejiang Province . [ Methods] According to the data from the National TB Manage-ment Information System,quarterly reports of project were collected and analyzed . [Results] The X-ray check rate and sputum test rate of newly diagnosed patients both reached more than 97%.The registration rate of active pulmonary TB and smear-positive TB were 71.45 per 100 000 and 26.41 per 100 000.A total of 1 393 new smear-positive pulmonary TB cases were detected .The completion of case finding target for new smear-positive pulmonary TB was 119.67%.The cure rate and treatment success rate for new smear-positive cases were 88.08%and 90.52%.And 1 657 cases have accepted psychological support .The psychological support rates were 36 .05%.A total of 39 361 person times for TB cases received free liver function test , and the test rate was 100%. [ Conclusion ] This project was implemented well in Wenzhou , and obtained good achievement .The discovery of new smear-positive patients , treatment outcome , psychological support and free liver function test for TB patients have reached the project requirements .
RESUMO
Objective To evaluate the implementing effects of the first round malaria control project supported by the Global Fund on malaria control in Sichuan Province so as to provide the evidence for intensifying the control strategy of malaria. Meth?ods Based on the requirements of the malaria project of Globe Fund the comprehensive malaria control measures including case identification health education and training for doctors were carried out. Results In 2007 the malaria incidence was 0.12/10 000 while it was 1.66/10 000 in 2002 with a reduction rate of 92.77%. The number of malaria endemic towns reduced from 13 to 2. The awareness rate of knowledge about malaria of the local residents rose from 26.86%to 79.83% χ2=403.00 P<0.01 with an increase rate of 197.21%. The awareness rate of knowledge about malaria of the students rose from 36.87%to 99.22% χ2=359.62 P<0.01 with an increase rate of 169.11%. Conclusions With the support of Globe Fund the trans?mission of malaria has been effectively controlled. The capacity of malaria control and the malaria control knowledge of the inhab?itants have been enhanced. The implementation of the project has significant effects on malaria control in Sichuan Province.
RESUMO
Objective To evaluate the implementation effect of Malaria Elimination Project supported by the Global Fund in Shaanxi Province so as to provide the evidence for the scientific implementation of Malaria Elimination Action Plan and the exami-nation and evaluation work. Methods The data of malaria prevention and control work were collected and analyzed statistically in 27 counties from 2010 to 2012 in order to evaluate the measures and effects of malaria control. Results There were 64 reported cases in the project areas from 2010 to 2012,and the average annual incidence rate was 0.15/10 million with a declining trend. The infected area sources of patients were mainly imported overseas accounting for 79.69%of the total cases. The blood completion rate of febrile patients was 94.14%,and the scope of the blood smears testing work had expanded to 88 counties(including 61 third-class counties). The training coverage rate of malaria prevention knowledge and skills had achieved to 100%. The awareness rates of malaria prevention and control were 91.68%and 89.44%in the students and local residentsrespectively. The case reporting with-in 24 h after diagnosed,epidemiological case study and outbreak disposal,laboratory testing and confirming and the other case management capabilities had also improved significantly. Conclusions The implementation of the Global Fund Malaria Project in Shaanxi Province has accelerated the process of Malaria Elimination work and improved significantly the malaria control ability in the project areas.
RESUMO
The study is to describe the main activities of NGOs involved in programs of China AIDS Global Fund Round 5 and analyze the advantage and necessity of their involvement in HIV/AIDS control. The experience and problems of NGOs ' involvement in AIDS Global Fund Programs,as well as appropriate approaches to address them are discussed.
RESUMO
Objective To evaluate the effectiveness of a project for treating TB/HIV co-infection(phase 1,2007-2008)supported by Global Fund in Wolong district.Method Data on project implementation in 2007-2008 were collected and analyzed.Results A total of 916 TB patients were diagnosed in 2007-2008,of whom 847 cases were detected for HIV antibody,with a detection rate of 92.47%.A total of 368 people living with HIV/AIDS were identified by screening 1790 persons/times,with a screening rate of 94.36%.Among them 55 cases of active tuberculosis were co-infected with HIV,of whom 3 were smear positive.After aniti-TB chemotherapy marked symptomatic improvement was witnessed in 37 cases;the curative rate for new smear positive cases reached 66.7% and the remission rate was 70.0%.Conclusion Satisfactory results were achieved in preventing and treating TB/HIV co-infection in Wologn district,and the experience gained in implementing the phase 1 project will provide useful information for implementing the project for the next phases.