Three Diseases, Three Decades: National and Global Programs Against HIV, Tuberculosis and Malaria

Uganda built one of the first national AIDS control programs in Africa inside its Ministry of Health. The 1987 five-year plan made health education the main thrust, alongside blood screening, safer sterile procedures and better surveillance.

Brazil's Ministry of Health laid the groundwork for its national AIDS program in 1986, and in 1987 placed it under a committee of scientists and civil society groups. The program has since expanded to a Test and Treat policy in 2013 and offered pre-exposure prophylaxis through the public system from 2017.

Thailand's program, first tried in a single province in 1989, required condom use with clients at every registered brothel. It was run through the National AIDS Committee chaired by the Prime Minister, so the rule was enforced at the establishment level rather than left to individual sex workers.

South Africa began preventing mother to child transmission at pilot sites in 2001. A court challenge brought by the Treatment Action Campaign led to a 2002 Constitutional Court order to make nevirapine available to pregnant women in all state hospitals and clinics.

Announced in 2003, the United States program funded HIV treatment, testing and prevention in more than 50 countries, concentrated in sub-Saharan Africa. It is coordinated through the Office of the U.S. Global AIDS Coordinator with USAID, the CDC and the Department of Defense.

UNAIDS set three linked targets for 2020: 90 percent of people living with HIV knowing their status, 90 percent of those diagnosed on sustained antiretroviral therapy, and 90 percent of those on treatment with viral suppression. It shows a program defined by a measurable chain of steps rather than a single intervention.

China implemented the DOTS strategy in 13 provinces between 1992 and 2001 with a World Bank loan, then widened it nationally. Its attention turns to migrant workers, who face higher risk and reduced access to subsidized treatment.

The World Health Organization recommended DOTS in the mid-1990s as its tuberculosis control strategy. Its core is a short-course drug regimen taken under direct observation, backed by reliable drug supply and standardized recording, and it remains the operational core of tuberculosis programs even after the End TB Strategy from 2015.

India reorganized its tuberculosis work into the Revised National Tuberculosis Control Programme in 1997, adopting DOTS nationwide under the Ministry of Health and Family Welfare. It was rebranded the National Tuberculosis Elimination Programme in 2020.

The Stop TB Partnership was established in 2001 to eliminate tuberculosis as a public health problem. Its secretariat sits in Geneva and has been administered by UNOPS since 2015, having previously been hosted by the World Health Organization.

Under the World Health Organization's Global Malaria Eradication Program, Sri Lanka's DDT spraying and rapid diagnosis cut cases from about one million a year to 18 in 1963. After later resurgence and renewed vector control, the country achieved WHO malaria-free certification in 2016.

In 1998 the World Health Organization, the World Bank, UNDP and UNICEF created Roll Back Malaria with the goal of cutting the global burden of malaria in half by 2010. It continues today as the RBM Partnership to End Malaria, convening more than 500 partners.

Created in 2001 by countries sharing the Amazon basin, this regional program had financial support from USAID and technical support from PAHO and the World Health Organization. It later expanded to eleven countries by adding Belize, Guatemala, Honduras, Nicaragua and Panama.

Launched in 2005 and led by USAID and the CDC, the initiative funds insecticide-treated bed nets, indoor residual spraying, rapid diagnostic testing, artemisinin-based combination therapy and preventive treatment during pregnancy. It began in sub-Saharan Africa and later expanded to the Greater Mekong Subregion.

The Zanzibar Malaria Control Programme was renamed the Zanzibar Malaria Elimination Programme, marking a shift from control to elimination under the Ministry of Health, Zanzibar. It works on reactive case detection, following up on notified cases to find further infections.