The Director's Corner

The Director's Corner

The world must re-evaluate its response to TB and give it the status of a public health emergency

 A message from José Luis Castro, Executive Director, The Union

This year’s theme for World TB Day is “Wanted: Leaders for a TB-free World. You can make history. End TB.”

Let’s consider this for a moment. Tuberculosis (TB) has been destroying populations for centuries. It is both a historical disease and today's biggest infectious disease killer. It is also treatable and curable. It is a terrible contradiction that latest figures show that nearly two million people lost their lives to TB in 2016. We know that, if not treated properly, TB mutates into a drug-resistant version (DR-TB) that is even harder to contain. Millions of patients have received inadequate treatment for normal, curable TB, and now DR-TB is a global epidemic too.

The elimination of TB would change the world. Such an event would enable economies and communities to recover and, in many instances, thrive. It would relieve healthcare systems and their staff of a significant treatment burden. It could allow people to reach their potential, live their lives to the full.

But the visionary leadership willing to make the necessary commitments to turn this into reality has been lacking. Perhaps it is complacency, an over-riding feeling that TB is someone else’s problem, that has contributed to such global neglect.

But now a combination of the global economic crisis and reduced investment in healthcare services has threatened national TB programmes, with the knock-on effect for TB control. TB is a global problem and affects all countries, regardless of status or economic wealth. There is no validity in an argument that the problem of TB can be delegated to some other region or organisation. We’re all in this together.

In 2018, we will see the first-ever United Nations’ High-Level Meeting (UN HLM) on TB, only the fifth time that the UN has called for an HLM on a single health issue. It is crucial that this meeting harnesses political support from the very top, committed to turning the global tide against TB and accelerating progress towards ending the disease. We must be able to look back on this meeting of governments and political leaders and say that this was the moment the balance shifted toward elimination.

With current progress in combatting TB stalled, there is the very real danger of not meeting the 2020 rate of decline of TB required by the World Health Organization’s End TB Strategy. Greater political and financial commitment is needed to urgently stop the rot. This World TB Day, The Union is advocating for action on some key areas that must be represented at the UN HLM on TB:

-US$2 billion for TB research and development (R&D). New vaccines, diagnostics and treatments can only be achieved with adequate and sustained funding commitments. Yet investment in TB R&D is only one-third of the nearly $2 billion in annual funding needed, so we need innovative tactics. The Life Prize is one such approach that can deliver inventive and collaborative financing mechanisms for R&D into new TB drugs and regimens. We need more like this.

-A global response based on human rights first. It is essential that anyone living with TB should know their status and receive the support they need to complete their treatment. For example, childhood TB is a lethal epidemic that is under-acknowledged globally. Children must be given the same rights to TB care, treatment and research, as adults.

-10 million by 2022. Everyone with TB needs to be treated. It is vital that heads of state across all sectors commit to the target of treating 10 million people annually by 2022. TB is not just a problem of ‘health’, it is devastating to economies, infrastructures and communities. To address it, we need to harness skills across many different sectors and an accountability framework that encompasses all elements of the TB response must be developed and enforced. This includes reviewing progress and results, with the ability to make what remedial action is necessary to keep the plan on track.

Without committed leadership, none of these things will happen. And TB will continue to be a disease that features in our past, present and future.

There is a very real opportunity in 2018 for our leaders to step up and make history by combining their will and their efforts to end a disease that has existed for far too long. This World TB Day, the world must commit to eliminating TB for good.

Statistics sourced via Global Tuberculosis Report 2017 – World Health Organization