Tuberculosis on the World Stage
Setting key targets and commitments for TB.
The fight against tuberculosis (TB) is in the spotlight now. Last month, on 26 September 2018, the United Nations (UN) held the first High-Level Meeting on TB titled “United to End TB: An Urgent Global Response to a Global Epidemic” in New York. Tuberculosis is only the fifth health issue ever addressed in UN meetings coming after HIV/AIDS in 2001, non-communicable diseases in 2011, Ebola in 2014, and antimicrobial resistance in 2015.
TB remains the deadliest infectious disease and a global public health threat. The World Health Organization (WHO) estimates that in 2017 about 10 million people fell ill with TB, and 1.6 million died, which is three people every minute. Thirty high TB burden countries including Tanzania, Mozambique and Ethiopia accounted for 87% of the world’s cases. While the TB burden is falling globally, the decline is not fast enough to reach the 2020 milestones of the WHO End TB Strategy, to which all Member States committed to in 2014.
TB is both treatable and curable, and treatment of detected TB cases averts millions of deaths every year. Strikingly, more than one third of all cases, 3.6 million, are missed due to underreporting and underdiagnosis, when people do not have access to health care or are not diagnosed when they do. Ten countries accounted for 80% of this case detection gap, Tanzania being one of them.
In response to this gap, the WHO, Stop TB Partnership and the Global Fund to Fight AIDS, TB and Malaria launched the initiative “Find. Treat. All.” aiming to detect and treat 40 million people with TB in the period 2018–2022. This target found its way in the UN declaration on TB together with a commitment to increasing annual investment in TB to $13 billion by 2022.
The UN High-level meeting on TB was meant to bring together Heads of State and Governments to step up the commitments and actions needed to accelerate progress towards ending TB. At the end of the day the delegates agreed on a political declaration. Key targets are summarized in the graphic below:
Source: StopTB Partnership
Commitments included to reach all people by closing the gaps on TB diagnosis, treatment and prevention, to transform the TB response to be fair, rights-based and people centered, to accelerate development of essential new tools to end TB and invest the necessary funds.
History shows that a declaration is not enough. For instance, thedeclaration of TB as a global health emergency in 1993 did not prevent it causing nearly 50 million deaths in the following 25 years. Therefore, the commitments from heads of state and governments towards decisive and accountable global leadership is particularly important.
The success of the UN High-level meeting will need to be measured against the implementation of these commitments globally. Several countries are taking ownership. According to media reports, India has tripled the budget dedicated to tackling TB; China, South Africa and Suriname are currently implementing new national strategic plans to close the gaps in diagnosis and treatment; and President Filipe Nyusi of Mozambique has vowed his commitment to mobilize all Mozambicans to work with partners towards eliminating TB.
At APOPO, we have been following the historic meeting and its aftermath with high interest. We identify with the set targets and continue our research into using TB detection rats as a new diagnostic tool and our field work in detecting additional TB cases every day.