The Director's Corner

We must work together and redouble our efforts to make 2018 a year of major progress in global health

A message for the year ahead from José Luis Castro, Executive Director, The Union

As 2017 ends we start to look ahead to a new year. It is a pertinent time to ask the questions that will inform our activity in the months ahead. What are the challenges and opportunities in the field of lung health? What do we – The Union – need to focus on as a priority?

We already have an agenda. The sustainable development goals (SDGs) are a fully-mapped out inventory of the basic tenets of public health that urgently need addressing – including universal access to treatment, ending global poverty and hunger, tackling fundamental inequalities and promoting health and well-being for all.

And the world is also committed to ending tuberculosis (TB) by 2030 – another global priority. Yet recent figures released by the World Health Organization (WHO)* confirm that progress towards that goal has stagnated. If TB is truly going to be eradicated, then much more urgency, commitment and funding than has been shown to date, is critically needed.

2018 affords a number of opportunities to make significant progress on all these fronts:

As the reality of tobacco control measures begin to bite, the tobacco industry searches for new and, in too many cases, vulnerable audiences for its deadly products. It is no coincidence that the 17th World Conference on Tobacco or Health (WCTOH) is in Cape Town, 7-9 March 2018 – a rebuttal to the ambitions of tobacco manufacturers who see Africa as a ripe market for expansion, as well as territory for advancing new and different products to increase its hold on consumers. The conference has already announced that public health champions, WHO Director-General, Dr Tedros Adhanom Ghebreyesus; South Africa Minister of Health, Dr Aaron Motsoaledi; and WHO Ambassador for Non-Communicable Diseases (NCDs), Michael R. Bloomberg have all confirmed their attendance. Join them by registering here:

One of the major topics at WCTOH will be how tobacco use is the leading preventable risk factor for NCDs. By 2025, if no further action is taken, over 320 million will have died from an NCD-related illness, a number equivalent to the entire population of the United States. Issues such as policy incoherence, inadequate financing and lack of political momentum are impeding progress on NCDs and, ultimately, the SDGs.

In 2018, the United Nations (UN) hosts its third high-level meeting (HLM) on NCDs, at which the imperative is on the public health community to demand policy from governments that puts societal health above the vested interests of the commodity industries, responsible for driving up health care costs and de-stabilising economies and communities alike.

Similarly, 2018 is significant for marking the first-ever UN HLM on TB. This meeting has to engage and harness the requisite political support to turn the global tide against TB. We must be able to look back on this meeting of Heads of States and say that this was the moment the balance shifted toward elimination.

In practical terms, this means thinking globally and putting words into action. Because the TB community, active though it is, cannot end TB without input from elsewhere. The TB epidemic is sustained by many broader issues and injustices – global poverty, stigma and discrimination, malnutrition, gender inequality issues, and lack of access to healthcare and drugs. TB is fundamentally an issue that affronts universal human rights – and to combat it, we need to harness the support of a broad group that encompasses governments and communities, healthcare specialists and advocates, all working together. The solution lies within all of us.

The 49th Union World Conference on Lung Health will be in The Hague, between 24-27 October. Fittingly, in a city that has social justice at its core, our theme will be ‘Declaring Our Rights: Social and Political Solutions’. Health is a human right – and access to health care services and treatments should be available to everyone, despite location, income and status. 

Our world conference has an excellent track record in highlighting areas of lung health that have previously been overlooked. This was particularly evident in Mexico in 2017, when our keynote speaker, Dr Jeffrey Starke, stunned delegates with his dissection of why childhood TB is neglected, despite there being one million cases of childhood TB annually and 210,000 deaths. He said, “TB is a treatable and preventable disease that, in children, is not being treated and certainly not being prevented. Only one-third of the cases are even recorded and reported…The current mortality rate of 21 percent is about the same as in the era before treatment was even invented”.

That this should be the situation when we are talking about the elimination of TB as an achievable reality is shocking and shameful. The Union will be advocating to governments and public health communities that funding must be allocated towards the better integration of health care systems to ensure children and adolescents receive TB diagnosis and care. That the needs of young people are included in national TB programmes. That investment into childhood TB research is an urgent priority. World TB Day on 24 March; the World Health Assembly between 21-26 May and, of course the UN HLM on TB are key moments for doing so.

TB and tobacco use have been around for so long, they create the mind-set that we can never truly eradicate them. This has to end. Let us all work together, combine our resources and our efforts to make 2018 the year that everything changed.

*Figures from Global tuberculosis report 2017 (WHO):