The world’s top three infectious diseases — HIV/Aids, tuberculosis and malaria — are losing ground due to the global attention being accorded to them, and the financial support being mobilised to fight them.

The number of people killed by the three diseases has declined significantly in the past 13 years, according to a landmark study published in the Lancet. The study attributes the success to the Millennium Declaration, in the year 2000, that brought global attention and mobilised financial support to fight the three diseases, which were killing millions of people, mainly in Africa.

The declaration also led to the formulation of Millennium Development Goal number 6 (MDG6), which aims at stopping the spread of HIV, and reversing the incidence of malaria, tuberculosis and other major diseases by 2015.

“Since 2000, the upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated,” the group of scientists who conducted the study said.

In fact, it is the global attention focused on the three diseases that led to the creation of the Global Fund in 2002, the US President’s Emergency Plan for Aids Relief (PEPFAR) in 2003, and the President’s Malaria Initiative in 2005.

The Millennium Declaration also helped to strengthen the Rollback Malaria Initiative, which was established in 1998 to fight the disease. The programmes have poured millions of dollars into Africa and Asia to ensure MDG6 is met.

READ: Most African countries unlikely to meet MDG targets before 2015: report

According to the study conducted from 2000 to 2011, multilaterals, bilaterals, foundations, and non-governmental organisations have invested $51.6 billion in HIV, $11.3 billion in malaria, and $8.3 billion on tuberculosis programmes. East African Community member states are among the top beneficiaries of the funds.

But there is a growing concern among countries in the region that the latest budgetary cuts by some Western countries could reverse the gains made and see infections and deaths rising to pre-2000 levels.

“Getting adequate funds to keep the three diseases under control will be a major challenge going forward. The money received from foreign donors has helped countries buy drugs, train medical personnel and also educate the public on prevention measures,” said Joseph Sitienei, head of communicable disease control at the Ministry of Health in Kenya.

Already, the US has reduced funding for the PEPFAR programme, forcing some non-governmental organisations operating in the region to scale down their anti-HIV intervention programmes.

Funding from the Global Fund is also expected to decline, since the US, one of the major contributors, has said it will provide no more than 33 per cent of the total contributions. As a result, according to UNAids, the US’s 2015 contribution to the Fund is expected to decline by $300 million.

“If funding declines it will definitely affect intervention activities already in place for the three diseases,” said Dr Sitienei.

On HIV, the study says, globally in 2013, there were 1.8 million new infections, 29.2 million prevalent HIV cases, and 1.3 million HIV- related deaths. At the peak of the epidemic in 2005, HIV caused 1.7 million deaths.

Through interventions including preventing mother-to-child transmission (PMTCT) and antiretroviral therapy (ART), 19.1 million life-years have been saved, 70.3 per cent of them in developing countries, notes the study.

“The funding from donors has helped the Kenyan government expand the response down to the community level and even involve the people living with Aids in the campaigns,” said the National Aids Control Council deputy director, Sobbie Mulindi. “East African governments now need to invest more in the health sector.”

However, despite the progress, research shows that 101 countries (74 of which are developing) still have increasing HIV incidence, which means continued funding will be crucial. HIV prevalence, for example, is still on the rise among vulnerable groups including people who inject drugs, prisoners, homosexuals and uniformed officers such as the armed forces and the police.

On tuberculosis, the study says that, including HIV-positive individuals, all-form incidence was 7.5 million, prevalence was 11.9 million and number of deaths was 1.4 million in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7.1 million, prevalence was 11.2 million, and number of deaths was 1·3 million.

READ: More children suffering from tuberculosis than recorded, study

Thanks to donor funding, Kenya, for example, was the first country in Africa to achieve the global tuberculosis targets set by the World Health Organisation in 2008. The treatment success rate is currently at 85 per cent and case detection rate is at 70 per cent.

In addition, Kenya was one of the first countries in Africa to start multidrug-resistant tuberculosis treatment in 2008. “The treatment has been successful achieving 70 per cent success rate, which is above the global target of 60 per cent,” said Dr Sitienei.

However, apart from inability to raise enough funds locally, East African countries still do not have the human resources to effectively treat tuberculosis, and the problem could worsen with the emergence of the multidrug-resistant variety.

“Other East African countries are facing the same challenges Kenya is facing but some are far behind. Uganda, for example, has not started treatment of multidrug-resistant tuberculosis. Tanzania started recently. Sudan and Somalia still rely heavily on Kenya,” said Dr Sitienei.

Multidrug-resistant tuberculosis takes a long time to treat and cost about ($23,000) for a single case.

For malaria, globally, the cases and deaths grew rapidly from 1990 reaching a peak of 232 million in 2003 and 1.2 million deaths in 2004. “Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31.5 per cent. Outside of Africa, malaria mortality has been steadily decreasing since 1990,” the study notes.

Waqo Dulacha, the head of Kenya’s National Malaria Control Programme, said tremendous achievements have been made in controlling the disease in the region, courtesy of increased global funding.

“Five years ago, 30 per cent of all outpatients in Kenya suffered from malaria, but now it is between 11 per cent and 12 per cent that is a major achievement,” said Dr Dulacha.