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AIDS, tuberculosis and malaria are three of the world’s largest killers among infectious diseases. An estimated 271 million people suffer from these three diseases combining for 3.6 million deaths each year. As a result, NGOs, IGOs and federal governments have allocated many resources to combat the spread and fatality of these epidemics. In 2007, $18 billion has been spent on combating AIDS, tuberculosis and malaria through awareness programs, prevention programs and research. The AIDS, tuberculosis, and malaria pandemics are intertwined with each other, as many of those in developing nations who suffer from AIDS also suffer from tuberculosis and malaria as well. These three diseases are the top three most funded diseases in the world. The amount of people infected, death toll and the demand for this funding has brought the fight against AIDS, tuberculosis and malaria to be one of the preeminent problems in the modern world. However, the support over these three diseases has caused a controversy, prompting critics to ask why these three specific diseases are more important than any other.

Overview
There is an estimated 33 million people who suffer from AIDs, 12 million from Tuberculosis and 225 million people who suffer from malaria. Despite this, malaria shows the most promise of these three diseases to be eradicated in the future despite its relatively high prevalence. The malaria epidemic is caused more due to impoverished situations than a lack of technology to treat and cure, the category AIDS would fall under. With no animal reservoir from which malaria could bounce back into the human population, once malaria is gone it will likely be eradicated.

History
The attention AIDS, tuberculosis, and malaria command has made them the main focuses of global health today. Throughout history, global health has focused on other diseases such as smallpox and rinderpest specifically in an effort to eradicate such diseases.

AIDS
AIDS is the syndrome caused by HIV. HIV attacks the human immune system, primarily CD4+ T-cells. When these CD4 cells drop below 200 cells per µL, the immune system is compromised and will not be able to fight off normal infections. People suffering from AIDS are at a higher risk for opportunistic infections that would not normally occur with a healthy immune system. AIDS does not directly show any symptoms, but the weakened immune system causes the patient to suffer from a wide variety of infections, ranging from simple bacteria and fungi to developing more serious diseases such as cancer. The leading cause of HIV-related deaths is tuberculosis.

HIV is transmitted primarily through unprotected sex, exposure to infected bodily fluids, or from mother to child during pregnancy, childbirth or breastfeeding. These three transmission methods can be largely prevented through higher awareness of the virus. Between the ages of 15-24, women are eight times more likely to be HIV positive than men. Thus, through awareness programs and human rights programs, we have been working towards resolving the AIDS pandemic. The AIDS pandemic has thought to have peaked in 1999. Since then, the number of new HIV infections has dropped each year.

Treating HIV and AIDS has been difficult because there is no known cure. The main treatment option is highly active antiretroviral therapy, where the patient is given different combinations of various antiretroviral drugs to help combat HIV.

Tuberculosis
Tuberculosis is spread through the air of infected people carrying the bacillus Mycobacterium tuberculosis. Symptoms include coughing and chest pain. Tuberculosis has a fatality rate of roughly one half if left untreated.

Tuberculosis is generally prevented through the Bacillus Calmette-Guérin vaccine, developed in 1905. However due to its unreliability of prevention many countries are working together to develop a new vaccine. The Global Plan to Stop Tuberculosis, outlined by the World Health Organization, calls for a newer, safer, more reliable vaccine along with better drugs. The antibiotics used to treat tuberculosis have been the same for forty years and newer drug-resistant strains of tuberculosis are starting to adapt to this. The WHO hopes to reverse the incidence rate and death rate of tuberculosis by 2015.

Malaria
Malaria is a disease carried by mosquitoes. Malaria is a parasite of the genus Plasmodium which eventually one's red blood cells. Malaria symptoms include headache, fever, shivering and nausea. In more severe cases, malaria causes comas and even death. When gone untreated, it is estimated that malaria has a fatality rate of roughly 10%.

Malaria has been eliminated by 27 separate countries that are officially recognized by the World Health Organization. For those countries still battling malaria, prevention efforts include indoor residual spraying and insecticide-treated mosquito nets. Mosquito nets have been the primary way of preventive care for malaria. However, there has been an issue with getting people at risk of malaria to consistently sleep under mosquito nets. Some such as William Easterly suggest selling mosquito nets at a subsidized cost in order to have people who buy the nets more likely to use them. Yet, this too has issues in itself because many families won't receive any mosquito nets unless they are given them for free.

Bill and Melinda Gates Foundation
The Bill and Melinda Gates Foundation is the single largest organization with the greatest impact on global health in terms of monetary funding. With $1.5 billion spent on global health initiatives annually, the Bill and Melinda Gates Foundation exceeds the spending of those such as the World Health Organization and the United States government. Their stated goal is to use science and technology to discover, develop and deliver practical and affordable vaccines, medicines and other health tools. The Bill and Melinda Gates Foundation has put a huge emphasis on creating and delivering vaccines.

" Our number one global health priority is creating and delivering vaccines for infectious diseases. Millions of lives can be saved in developing countries by ensuring access to effective vaccines that already exist and by developing new vaccines for use."

Through its Global Health Program the Bill and Melinda Gates Foundation has worked towards reducing the burden of HIV/AIDS, tuberculosis, and malaria. Research into vaccines for HIV/AIDS and malaria and updating the tuberculosis vaccine are just a few of the many goals of the Global Health Program. Through the end of 2009, the Global Health Program has provided antiretroviral treatment to 2.5 million people, tuberculosis treatment to 6 million, and delivered 104 million insecticide treated mosquito nets. This culminates in saved an estimated 5 million lives from AIDS, tuberculosis and malaria.

President's Emergency Plan for AIDS Relief
The President's Emergency Plan for AIDS Relief was signed in 2003 by George W. Bush. Initially providing close to providing $19 billion over five years to various programs supporting HIV/AIDS treatment and prevention around the world, PEPFAR was the single largest effort by one country to combat a single disease. In 2008, PEPFAR's funding was renewed by Congress, who agreed to provide up to $48 billion over the following five years (PEPFAR). The renewal also redefined and broadened PEPFAR's scope from just HIV/AIDS to tuberculosis and malaria as well.

PEPFAR emphasizes sustainable country programs among developing nations focusing on prevention, treatment, and care. This includes building partnerships between governments and strengthening the governments' ability to react and respond to the pandemic as a whole. This will allow the other countries to continue providing assistance to their own people in the long run with the same programs that PEPFAR was able to initially help start. Transitioning from emergency response to sustainable country programs is one of the main goals PEPFAR outlined. Other goals include integrating HIV/AIDS programs with other health programs, such as tuberculosis and malaria, and investing in research to help the future of combating AIDS.

Criticism
The race in eliminating and eradicating these three diseases has produced some criticism. Some critics believe that argue that the way the world has approached eliminating each pandemic is incorrect. Many large organizations, such as the World Health Organization or the Bill and Melinda Gates Foundation, approach tackling these diseases through advanced treatment and research for cures for future eradication, rather than preventive care to target the problem now. Others ask why these AIDS, tuberculosis, and malaria are any more important than other lethal, preventable diseases such as polio, or non-communicative diseases.

Despite all of the overwhelming good the Bill and Melinda Gates Foundation has delivered, some critics do complain about the method of their actions. By focusing so much of its resources on AIDS, tuberculosis and malaria, the foundation has failed to solve the underlying problems in the areas they are trying to help, thus hindering the foundation's goal of providing treatment for these three diseases. For example, the foundation provides money for AIDS treatment, but its patients suffer from hunger, which needs to be taken along with the medicine. Without adequate nutrition, the medication's effect is mitigated.

The focus on AIDS, tuberculosis and malaria has moved attention away from other important diseases. Polio, for example, was on the brink of eradication before bouncing back due to a variety of reasons, one of which could be attributed to a lack of funding. While the funding for AIDS, tuberculosis, and malaria is important and has saved many lives, the eradication of the third disease ever in human history failed in part due to a lack of funding. Because no cure exists for polio, the only way to eradicate polio is through achieving herd immunity. A number of factors have prevented this from occurring, one of them being a lack of monetary resources. If more money was directed towards eliminating polio earlier, it is possible that the eradication of polio would save more money to then be used for combating AIDS, tuberculosis, and malaria and other health concerns.

Other critics look to non-communicative diseases such as heart disease and high cholesterol as issues that resources can be better used towards. These non-communicative diseases actually account for more deaths worldwide than AIDS, tuberculosis and malaria do. Others see improvements in water quality and standard of living in developing nations as a more admirable cause. Critics claim that more people would be saved if the money and attention devoted to AIDS, tuberculosis, and malaria were better allocated. In 2007, the United States spent almost 100 times more money on combating AIDS than on access to clean water, the primary cause of diarrhea in developing nations. Internationally, AIDS spending accounts for 25% of international healthcare aid despite only causing 3.7% of global deaths. The discrepancy between spending on AIDS, tuberculosis and malaria and other health issues brings up the question of why these three diseases are any more important in public health than any other.