Evaluating the Impact of the Global Fund on Fighting Against Tuberculosis

Posted: 14 Jun 2007

See all articles by Chunling Lu

Chunling Lu

Harvard Initiative for Global Health

Catherine Michaud

Harvard University

Andrew Stokes

Johns Hopkins University

Christopher Murray

University of Washington - Health Metrics and Evaluation

Date Written: June 2007


Rationale: In spite of the fact that a cost-effective cure for tuberculosis (TB) was developed more than fifty years ago, about two billion people - comprising one third of the world's population - are infected with the mycobacteria that cause TB. Of those infected two million die of this air-borne infectious disease each year. At the same time, we are facing two new challenges: the rising incidence of drug-resistant TB disease and the growth of the HIV/AIDS pandemic. The Millennium Development Goals proposed that, by 2005, the detection rate of new smear-positive cases should be raised to 70% and successful treatment of these detected case should reach 85%. Unfortunately, we have failed to achieve these goals. The Global Fund was created in 2002 to combat AIDS, TB and Malaria by raising and disbursing funds to countries. To date, the Global Fund has approved 81 grants in 69 countries for TB and TB/HIV co-infection programs and has disbursed about 426 million dollars to recipients.

Objective: In this study, we want to investigate, after several years of implementation, whether or not the Global Fund has contributed to achieving the targets set by the MDGs.

Methods: To assess the performance of Global Fund spending against the MDG goals for TB control, we use data till 2005 from various sources. The outcome variables - case notification rates with new smear positive and treatment success of smear positives - are from WHO's Global TB Database. Disbursement information was obtained from the Global Fund and other independent variables such as GDP per capita and indicators of government effectiveness were obtained from UN, World Bank and IMF online databases. Various estimation methods and model specifications are tested. A panel analysis using the fixed-effects model is finally adopted for this study. We also assume different timing of the effect to examine the sensitivity of our findings.

Results: We find that the Global Fund has a positive effect on case notification rates and estimates are significant. The results are robust to various model specifications and timing of effect. The preliminary results also show that there is a positive impact of Global Fund spending on countries with high-TB burden or low income countries.

Conclusion: With the data observed, we find that Global Fund spending is helping recipient countries to improve case notification rates.

Suggested Citation

Lu, Chunling and Michaud, Catherine and Stokes, Andrew and Murray, Christopher, Evaluating the Impact of the Global Fund on Fighting Against Tuberculosis (June 2007). iHEA 2007 6th World Congress: Explorations in Health Economics Paper, Available at SSRN: https://ssrn.com/abstract=992292

Chunling Lu (Contact Author)

Harvard Initiative for Global Health ( email )

104 Mt Auburn St
3rd floor
Cambridge, MA 02138
United States

Catherine Michaud

Harvard University ( email )

1875 Cambridge Street
Cambridge, MA 02138
United States

Andrew Stokes

Johns Hopkins University ( email )

Baltimore, MD 20036-1984
United States

Christopher Murray

University of Washington - Health Metrics and Evaluation ( email )

Box 356340
1925 N.E. Pacific Street
Seattle, WA 98195-6340
United States

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