People, partnerships and prevention
José Luis Castro, 31 July 2019
As we approach The Union’s Centennial and develop our new five-year strategy, I have been reflecting on our movement’s historic achievements, and on what is needed to achieve success now and in future.
Almost 100 years ago, our founders came together to create an organization that would develop the evidence base for ending the TB epidemic and spread that knowledge around the world. The Union has since developed into a global movement that has achieved huge progress and saved millions of lives.
Today, we are at a critical point on this journey, and have a unique opportunity. The 2018 UN High Level Meeting on TB united the world’s governments around a common agenda with milestones for action and a political commitment. Now, it is up to us - health professionals, scientists and researchers, survivors and members of affected communities, civil society activists, parliamentarians and many others - to work together in cooperation to ensure governments fulfill the commitments they have made to their people.
This offers great hope, and to achieve our vision of a world free from TB and lung disease, I believe we must focus on people, partnerships and prevention.
An emphasis on people means ensuring that solutions are informed by the lived experience of survivors and communities affected by TB and lung disease. Their voices are vital in ensuring that the solutions we develop are people-centered and informed by the best available evidence.
Partnership means moving beyond a relatively small community of experts to network and engage with a much greater range of actors. The UN political declaration commits to working across sectors including nutrition, finance, labour, social protection, education, science and technology, justice, agriculture, the environment, housing, trade, development and with greater cooperation between the public and private sectors.
We need help from these new partners to invite fresh thinking into the design of new solutions; and to help us scale up the solutions that we know work. Breaking down silos is a challenge that virtually all organizations and communities face. But if we reach out intentionally, we can build the bridges with the new partners and allies we need to end TB. This will be a strong theme of our new strategic plan, and our Centennial programme, and we are already engaging with corporate CEOs in the run-up to our 50th World Conference in Hyderabad.
And crucially, we need to focus on prevention. This week, colleagues at the IAS Conference launched a call to action to reach out to six million people living with HIV with preventive treatment for TB. We also announced a new collaboration with Sanofi on developing online training on the management of latent TB infection (LTBI).
As I wrote last month, we must invest urgently in prevention to have any hope of ending the TB epidemic. By systematically providing preventive therapy to high-risk groups like children, new infections annually, we can significantly reduce the number of people suffering from TB and chronic lung conditions as a result.
Without addressing the reality that a quarter of the world’s population are infected with latent TB, we will never achieve our goals. Following the HLM commitments, there is now a push to put 30 million people on TB preventive treatment by 2022. And focusing on prevention is a game-changer in other ways. When we emphasise the rights of people to access prevention, TB elimination becomes rooted in the needs of people and families, and becomes a core part of achieving Universal Health Coverage.
In 1920 there were no antibiotics, let alone DNA amplification or genomic sequencing. Today, despite new challenges, we have the knowledge, tools and capacity for worldwide cooperation that The Union’s founders could not have foreseen. Their courage and vision should inspire us to be more optimistic about ending TB and lung disease than ever before.