MESSAGE FROM OUR EXECUTIVE DIRECTOR - DR CASSANDRA KELLY-CIRINO
It is total injustice and failure by us all that millions of people around the world are still at high risk of tuberculosis (TB). There are simply no more excuses for the inequity and suffering from this preventable disease.
By using great breakthrough technologies – ultraportable radiology with AI reading, rapid molecular diagnostic tests and shorter treatment regimens for all forms of TB – with the public health, clinical and operational knowledge we have had for decades, we can end TB.
We must be brave and recognise that our current approach is not going to achieve our goals – ending TB by 2030 or 2035.
The Union calls for a focus on evidence-based policies and programmes that will break the chain of transmission to end TB in high-burden settings – finding and treating everyone with TB.
While many people in high-income countries believe TB is a disease of the past (because it generally is, in their countries), it is very much present and impacting lives, in most countries of the world. It is an ancient disease that thrives on the kind of instability we are currently seeing due to conflict, political uncertainty and climate change.
TB is an airborne infectious disease that does not respect borders. We all must play our part in eradicating TB in high-burden settings. TB anywhere is TB everywhere.
There is no ignoring the devastating impact the US Government’s decision to cut funding is having on global health and the most vulnerable people in our communities.
The incredibly difficult funding and geopolitical landscape means that we have to be more strategic and prioritise our efforts on interventions that will have the most impact on reducing TB incidence rates. The reality that donor-funding for TB control is not infinite, or indefinite, has always been true. Recent events have brought this reality into sharp relief. The only solution to the problem of TB is to end it, soon, not to plan for long-term and expensive “control” programmes. When it is “ended” the cost of keeping it “ended” will be very small. We have achieved this goal in some countries. We need to achieve it everywhere, soon!
The interventions to end TB already exist – community-wide active case finding linked to effective treatment of people who have TB.
In high-burden settings we must prioritise finding and treating everyone with TB. This is the only way to stop more people from being exposed, becoming infected, and infecting others. This is how we to break the chain of transmission and end TB once and for all.
Community-based interventions can only be successfully implemented with the full support and empowerment of communities.
The effectiveness of this approach to end TB was proven during the latter half of the 20th century in several countries in Europe, North America, east Asia and Oceania, as well as Cuba.
ROI needs to be redefined from only meaning ‘return on investment’ to also meaning ‘reduction of incidence’.
There are people who question the value and cost of community-wide active case finding, but that is often because they are using the wrong measurement.
Calculating the number of people needed to be screened to detect a single person with TB completely ignores the prevention benefits of finding and treating people with infectious TB.
The goal of the intervention is to end TB by breaking the chain of transmission, making the reduction in the incidence of TB the relevant success measure. The number of people with TB who remain undetected, rather than the number of people detected with TB, is a more appropriate ‘return on investment’ gauge.
Now is not the time to cut funding and engagement in the fight against TB – we can do that once the job is done.
We urge communities to pressurise their leaders to end TB. In 2025, no one should expect to be at high risk of being infected with TB.
The Union calls on world leaders and donors to fulfil their commitment to end TB, by significantly investing in breaking the chain of transmission to ensure all their citizens are safe from being infected in the future.
The lung health community’s pathfinder.
We will continue to play our role as the organisation that pushes for the identification and adoption of evidence-based approaches to everything we do, by:
- Focusing on the demonstration and refinement of approaches that successfully break the chain of TB transmission in high-burden settings.
- Disseminating the latest knowledge to those who need it and ensure that it is applicable to low-resource contexts.
- Providing platforms for members, communities and partners to engage on best practices for addressing the elimination of TB and lung diseases.