We look back at some of the highlights from The Union’s activities during 2017.
Following the release of the World Health Organization’s (WHO) list of antibiotic-resistant ‘priority pathogens’ which excluded tuberculosis (TB), The Union successfully campaigned for its inclusion. In September 2017, the WHO released the Priority Pathogen Report and highlighted drug-resistant TB as a priority for research and development in the battle against antimicrobial resistance.
Throughout 2017 The Union campaigned for increased investment into research and development for TB. The Union is working with a number of partners on a new mechanism, The Life Prize to incentivise new funding into TB R&D, to unite researchers to develop a one-month (or shorter) treatment regimen for all types of TB, which works for everyone, everywhere.
STREAM, the first large-scale, multi-country trial to evaluate shorter treatment regimens for multidrug-resistant tuberculosis (MDR-TB), released preliminary results from Stage 1 of the trial. The results showed that the nine-month treatment regimen tested achieved favourable outcomes in almost 80 percent of those treated. Although the trial results did now show the efficacy of the nine-month trial to exceed those of the 20-24 month regimen, the trial setting meant that more patients completed treatment on the 20-24 month regimen than is often the case in real-life settings. In routine programmes unable to achieve the high STREAM retention rates, the nine-month regimen may actually perform better in comparison.
The STREAM trial also enrolled its 100th patient in Stage 2 of the clinical study. Stage 2 is investigating an additional all-oral nine-month treatment regimen for MDR-TB, which would eliminate the painful injections that cause some of the severest side effects associated with treatment.
On World TB Day, The Union looked for ways to accelerate progress against the challenges that remain in ending TB. José Luis Castro addressed a high-level summit of parliamentarians representing the G20 in Berlin, and spoke in Seville, Spain, urging acceleration of action against TB. And around the world, Union offices organised and participated in rallies, spoke with the press, convened meetings and advocated on behalf of patients for more funding, increased political will and the end to TB stigma.
The Union continued to make child TB a priority in the lead up to the United Nations High-Level Meeting on TB, to be held in 2018. The DETECT Child TB project in Uganda, which saw TB diagnosis in children increase from under 5 percent to 40 percent in its first year, continued to strengthen district- and community-level healthcare delivery to improve childhood TB case finding, treatment and prevention. The project is designed to develop and test a model that can be applied at different levels of health care to address the health system challenges that are currently contributing to low detection of TB among children.
Project Axshya, The Union’s extensive civil society initiative working to strengthen TB care and control in India through advocacy, communication and social mobilisation, has reached over 17 million people from vulnerable and marginalised populations with information on TB symptoms. Axshya, working in partnership with seven sub-recipient partners, more than 1,000 local NGOs and nearly 15,000 volunteers, facilitated the diagnosis and treatment of over 25,000 TB patients.
On World No Tobacco Day, The Union participated in a high-level event held in conjunction with the UN Principals for Responsible Investment initiative and four major finance companies, that released a statement affirming their public support for international efforts to reduce tobacco use under the WHO’s Framework Convention for Tobacco Control.
China’s fourth most populous city, Shenzhen, became 100 percent smoke-free after a law banning smoking in all indoor public places came into full force on 1 January 2017. More than 20 million people are now protected from the harms of second-hand smoke. The Union supports the Shenzhen Non-Communicable Disease Control and Prevention Centre through technical assistance under the Bloomberg Initiative to Reduce Tobacco Use and worked with the municipal government and partners to launch this new phase of the smoke-free policy.
The TB-Free India Summit brought together top government officials and members of parliament along with big-name Indian celebrities to raise awareness and increase momentum to the fight against TB. The event brought a national focus to the issue of TB and galvanised support and commitment from key stakeholders, including from government, politicians, corporate partners and donors to pool resources to end TB in India.
The Union’s Centre for Operational Research continued to enhance operational research capacity in TB, HIV/AIDS and NCDs around the world through its training courses. Two-thirds of the research published as a result was found to have had a concrete impact on public health policy or practice 18 months after publication.
On World AIDS Day, The Union’s scientific publication, the International Journal of Tuberculosis and Lung Disease (IJTLD), featured editorials addressing the current state of TB-HIV diagnosis and treatment and measures to improve both. Read the editorials here: World AIDS Day 2017 and Test and treat for TB-HIV.
The Union Office in Myanmar provided antiretroviral therapy to more than 28,000 people living with HIV through its Integrated HIV Care programme, implemented in collaboration with the National AIDS Programme and the National TB Programme. Union staff and volunteers in Myanmar also conducted active case finding activities for TB, including facilitating over 7,000 health information sessions and referring 10,000 people showing TB symptoms for testing.
The Union’s Zoonotic TB sub-section collaborated with the World Health Organization, the World Organisation for Animal Health and the Food and Agricultural Organization of the United Nations to publish the first-ever Roadmap for Zoonotic TB, which addresses the major health and economic impacts of the disease.
The Nurses and Allied Professionals sub-section released an update to the guide Best Practice for the Care of Patients with Tuberculosis: a Guide for Low-Income Countries and the Adult and Child Lung Health section successfully applied to add a combination inhaler to the WHO Essential Medicines List, which will significantly improve the outcome of people with asthma in low- and middle-income countries.
Scientific region conferences in North America, Africa and the Asia Pacific brought together Union members, researchers, policy-makers, lung health experts and advocates to focus on regionally-specific questions and interventions to improve lung health. Union Region Conferences are driven by the member organisations in each region and are at the heart of their success.
The Union World Conference on Lung Health was distinguished by some of the most innovative science for combatting TB and its co-infections seen in recent years -- supporting the conference theme: ‘Accelerating Toward Elimination’. Delegates from more than 100 countries attended the four-day scientific programme of plenaries, symposia and abstracts presented by global experts.
Uruguay hosted the WHO Global Conference on Non-Communicable Diseases in Montevideo in October. The Union’s Executive Director, José Luis Castro, and Legal Advisor on Tobacco Control, Gustavo Sóñora, attended the conference on personal invitation from President Vázquez. They met privately with Vázquez prior to the conference to discuss their dedication to reducing NCDs globally and Uruguay’s proven record prioritising the health of its people.
In November, national delegations from 118 countries including over 70 Ministers of Health and other sectors attended the WHO’s Global Ministerial Conference on Ending TB in the Sustainable Development Era, reaffirming their commitment to ending the TB epidemic by 2030. A study, launched by the Global TB Caucus prior to the conference reported that the TB epidemic will cost the world economy close to US$1 trillion by 2030 unless progress is drastically accelerated. The momentum from this meeting will guide The Union, its partners and the global TB community towards the UN High-Level Meeting on TB in 2018.
Photo credits: Will Boase, Javier Galeano, Steve Forrest, Aditi Sharma, Courtesy of the Shenzhen Center for Non-Communicable Disease Control, Jan Schmidt-Whitley, Dasha Burns, David Andoh, Marcus Rose, Gustavo Sóñora, World Health Organization.