The Director's Corner

The Director's Corner

A message from José Luis Castro for World TB Day

Last month, US President Barack Obama’s administration proposed a cut of 19% to USAID’s budget to combat tuberculosis. This comes just a few short weeks after the announcement of the US government’s much-lauded National Action Plan for Combating Multidrug-Resistant Tuberculosis (MDR-TB), a disease that is increasing year on year and is now at epidemic proportions. If the new proposal is made law, that part of the budget that funds bilateral TB programmes will suffer a loss of US $45 million. 

I make reference to this on World TB Day 2016 - which appropriately has as its theme ‘Unite to End TB’ - because now more than ever it is collective action that will make a difference and eliminate this rampant disease for good. 

The proposed funding cut by the US government is devastating when we need all the financial and human resources we can muster.

The facts of the current TB crisis stop us in our tracks. Despite being curable, TB is still the cause of 1.5 million deaths, the world’s leading cause of death from a communicable disease. The figures are worse when we look at the impact of multidrug-resistant TB (MDR-TB). The World Health Organization reports that by best estimates, 480,000 people contracted this strain in 2014. Three quarters of people with this disease never even receive a diagnosis – and only half of those who actually begin treatment are treated successfully.  Drug resistance reminds us that TB is always changing and our response must also change – dramatically so.

The new ‘Global Plan to End TB, 2016-2020’, calls for a ‘paradigm shift’ grounded in human rights and gender equality, with political support at the highest level. It also states that focus on patients and communities should be of paramount concern.

In a piece here I spell out five crucial ways that I believe will help us bring about this paradigm shift and enable us to confront TB resistance.

Earlier this month, The Union hosted a group of national and international journalists on a field trip to the Sonepat area in the Indian state of Haryana, some 50 kms outside of Delhi. We wanted to demonstrate to them how the delivery of community-driven tuberculosis services under the umbrella of Project Axshya - meaning ‘Free of TB’ – are working to improve access to quality TB care and control through a partnership between government and civil society.

Implemented by The Union South-East Asia office with support from the Global Fund, Project Axshya supports India’s Revised National TB Control Programme (RNTCP) to expand its reach, visibility and effectiveness by engaging community-based providers to improve access to TB services, especially for women, children, marginalised, vulnerable and TB-HIV co-infected populations in low-income regions.

The outcomes are encouraging and indicate the progress that has already been made. For example, between 2013-2015, the project reached over eight million households, identified and tested over 300,000 people with symptoms suggesting TB, and diagnosed nearly 21,000 TB patients who were initiated on treatment.

This is what can be achieved when communities are empowered to make the decisions about the type of care that best suits them and their region, while drawing on expertise from the wider TB community. Governments worldwide must engage with the process and enable progress.  Sustainable, consistent funding must not only be promised but delivered.

On World TB Day, I renew The Union’s commitment to tackling head-on resistance in all its forms. The 47th Union World Conference on Lung Health to be held in Liverpool this October, takes this as its very theme: Confronting Resistance – Fundamentals to Innovations.  I look forward to seeing as many of you as possible there.

José Luis Castro
Executive Director
The Union