Global Tuberculosis Report -- 2012.pdf

5.1 Funding for TB care and control bycountry group, 2006–2013In the 104 countries for which trends in TB funding since2006 can be assessed and that report 94% of the world’sTB cases (listed in Table 5.1), funding is expected to reachUS$ 4.8 billion in 2013 (Figure 5.1). This is an increasein real terms from US$ 3.4 billion in 2006 and a smallincrease from US$ 4.6 billion in 2012.Brazil, the Russian Federation, India, China and SouthAfrica (BRICS), which report 48% of the world’s TB cases(Chapter 3), account for US$ 3 billion (63%) of theexpected total of US$ 4.8 billion in 2013 (Figure 5.1). Theother 17 high TB burden countries (HBCs) outside BRICS(listed in Table 5.2), which report 34% of the world’s TBcases, account for US$ 0.6 billion. A group of 10 Europeancountries other than the Russian Federation accounts fora further US$ 0.5 billion (80% of which is accounted forby three countries: Romania, Turkey and Uzbekistan).Patterns of funding for multidrug-resistant TB (MDR-TB) specifically are different, as described in Box 5.1.5.2 Funding for TB care and control bycategory of expenditure, 2006–2013In each year 2006–2013, the largest share of funding hasbeen used for the diagnosis of TB and treatment withfirst-line drugs (all categories of expenditure except thoselabelled MDR-TB in Figure 5.2 and Figure 5.4). However,funding for the diagnosis and treatment of MDR-TB hasbeen increasing and is expected to exceed US$ 0.7 billionin 2013 (Figure 5.2). Much of the increase is accounted forby BRICS, but allocations are increasing in other HBCsand the rest of the world as well (Figure 5.4).The relatively small amounts of funding reported forcollaborative TB/HIV activities (see Chapter 7 for furtherdetails) reflect the fact that funding for most of theseinterventions (including the most expensive, antiretroviraltreatment) is usually channelled to national HIVprogrammes and nongovernmental organizations ratherthan to national TB control programmes (NTPs).5.3 Funding for TB care and control bysource of funding, 2006–2013Domestic funding from national governments is thesingle largest source of funding for TB care and control(Figure 5.3), accounting for 90% of total expected fundingin 2013. 1 Of the remaining 10% that is expected fromdonor sources in 2013, most (88%) is accounted for byFIGURE 5.1 Funding for TB care and control in 104countries reporting 94% of global cases,by country group, 2006–2013US$ billions (constant 2012 US$)5432103.4 3.33.63.94.04.54.64.82006 2007 2008 2009 2010 2011 2012 2013Low- and middleincomecountries,excluding HBCs andEuropeLow- and middleincomecountries ofEurope, excludingthe RussianFederationHBCs, excludingBRICSBRICSFIGURE 5.2 Funding for TB care and control in 104countries reporting 94% of global cases,by line item, 2006–2013US$ billions (constant 2012 US$)5432103.43.33.63.94.04.54.64.82006 2007 2008 2009 2010 2011 2012 2013General health-careservices: MDR-TBGeneral health-careservices: DOTSOtherPPM/PAL/ACSM/CBC/OR/surveysTB/HIVMDR-TBDOTS aaDOTS includes funding available for fi rst-line drugs, NTP staff, programmemanagement and supervision, and laboratory equipment and supplies.FIGURE 5.3 Funding for TB care and control in 104countries reporting 94% of global cases,by source, 2006–2013US$ billions (constant 2012 US$)5432103.4 3.33.63.94.04.54.64.82006 2007 2008 2009 2010 2011 2012 2013Global FundGrants (excludingGlobal Fund)Government,general health-careservicesGovernment, NTPbudget (includingloans)1Domestic funding includes funding for outpatient visits andinpatient care in hospitals, the costs of which are not usuallyincluded in NTP budgets and expenditures. The amount ofdomestic funding for these inputs to TB treatment are estimatedby combining data on the average number of outpatientvisits and days in hospital per TB patient reported by countrieswith WHO estimates of the unit costs of outpatient visits andbed-days (see www.who.int/choice).GLOBAL TUBERCULOSIS REPORT 2012 53