# Box 3. Fight against AIDS, Tuberculosis and Malaria

The three infectious diseases—HIV/AIDS, tuberculosis (TB), and malaria—claim the lives of approximately 5 million people worldwide each year. $ ^{*} $ The spread of such infectious diseases represents a grave threat to the safety of humankind, and it is one of the biggest issues facing the international community. Developing countries in particular hold some regions where 30-40% of the working population is already infected with HIV. As well, the rapid increase in AIDS orphans and mother-to-child transmission (MTCT) impedes developing countries' growth. However, it can be sufficiently prevented and medically treated; it may be said that the issues for developing countries lie in the inadequacy of funding, human resources, and healthcare infrastructure.

Against this background, the Global Fund to fight AIDS, Tuberculosis, and Malaria (Global Fund) was set up in Geneva, Switzerland in 2002, to provide grant aid for prevention, treatment, and caring support work for HIV/AIDS, TB, and malaria in developing countries. Discussions at the G8 Kyushu-Okinawa Summit in 2000 that took up countermeasures against infectious diseases as one of the main agendas for the first time at such Summits had led to the establishment of the Global Fund. The above backgrounds grant the reason why Japan has been acknowledged as “birthparent” of the Global Fund. The establishment of the Global Fund becomes one of the major examples to observe Japanese leadership in the international community.

One of the major uniqueness of the Global Fund is derived from its system where a diverse range of bodies including governments, private entities in donor countries and developing countries participate in the formulation, approval, and implementation of projects. Governments, multilateral and bilateral aid organizations, non-governmental organizations (NGOs), private foundations, communities of infected people, religious organizations, research institutes, and the private sector participate in the principal bodies designed to carry out the project formulation and application process known as the Country Coordinating Mechanisms (CCM) in developing countries. The board of CCM that carries out the approval process consists of various sectors such as governments, NGOs, the private sector, foundations, and communities of infected people. As well, a variety of organizations play a role in the Principal Recipients that implement projects. In addition, the Global Fund does not implement projects but transfers funds to support countermeasures against infectious diseases. Governments of developing countries, international organizations, and NGOs mainly take responsibility for executing projects. In terms of project formulation, applications, and monitoring, projects should be designed in line with recipient countries' plans to encourage self-help efforts, with respect for their ownership.

As of the end of November 2008, the Global Fund has approved a total of US$14.6 billion for 621 projects in 140 countries. Approximately 60% of this amount is being used to assist Sub-Saharan Africa, which suffers serious problems in this issue. Around 61% of the approved financing has been used for countermeasures against HIV/AIDS, approximately 25% and around 14% for malaria and TB respectively.

The Global Fund’s activities have saved the lives of approximately 2.5 million people up to the end of 2007.

As a leader in establishing the Global Fund, Japan plays a crucial role in the administration and management of the fund, serving a member of the Board, or the highest decision-making authority. Japan has contributed to the Global Fund US$850 million, and decided to add US$560 million from 2009 onward for the foreseeable future. In March 2004, political, government-administrative, business, and academic circles within Japan jointly launched "Friends of the Global Fund, Japan," consisting of 20 members. The group was formed for the first time in the international community as a supporting organization for the fund. As well, for developing countries to pursue their development plans with the Global Fund, JICA as well as Japanese NGOs take part more frequently. In order for the assistance by the Global Fund to be provided more effectively, Japan is being engaged in various types of cooperation.

Goals and achievements of the Global Fund to 2009

2004	2005	2006	2007	2008	2009
HIV: Treatment with ARV $ ^{1} $ therapy (Number of people)	Goal	125,000	350,000	600,000	875,000	1,200,000	1,600,000
Achievement	130,000	384,000	770,000	1,400,000	2,000,000
TB: Treatment with DOTS $ ^{2} $ (Number of people)	Goal	300,000	700,000	1,200,000	1,800,000	2,600,000	3,500,000
Achievement	385,000	1,000,000	2,000,000	3,300,000	4,600,000
Malaria: Distribution of ITNs $ ^{3} $ (Number of nets)	Goal	2,000,000	5,000,000	15,000,000	30,000,000	60,000,000	100,000,000
Achievement	1,350,000	7,700,000	18,000,000	46,000,000	70,000,000

1. Anti-retroviral medication: medication that is effective in impeding the multiplication of the AIDS virus.

2. Treatment with directly observed treatment-short course; a method in which patients go to a hospital for taking medication, rather than the medication simply being handed over to the patient.

3. Insecticide-treated nets: mosquito nets that are infiltrated with insecticidal material.