We look back at some of the highlights from The Union’s activities during 2019.
The 50th Union World Conference on Lung Health in Hyderabad, India, followed the theme Ending the Emergency: Science, Leadership, Action, focusing on what is needed to ensure commitments become action, and that lifesaving targets are met.
Among the breaking news announced at the conference was the landmark agreement between Sanofi, Unitaid and the Global Fund to significantly lower the price of rifapentine, a critically important drug for tuberculosis (TB) prevention.
Also announced, during the second TBScience 2019 pre-conference, were the results of a trial for a new TB vaccine known as M72/AS01E and developed by GlaxoSmithKline, which contributed to preventing TB in 50 percent of people receiving it, representing a significant advancement towards ending the TB emergency.
The Union welcomed two new Editors in Chief to the International Journal of Tuberculosis and Lung Disease (IJTLD), and published numerous articles and editorials on Union studies, on topics including: Global Fund investment in operational research; the need for a target to address health-related quality of life post-TB treatment; improved local use of TB data in Zimbabwe, and preventing TB in people living with HIV. Other research from the IJTLD highlighted issues ranging from the use of animal models to explore the dual burden of TB-diabetes to the impact of World TB Day.
And Union researchers published articles in other journals on topics including: treatment for TB infection, translating TB treatment guidelines into national strategic plans; the impact of smoking cessation activities on people who underwent TB treatment; adolescent-specific care in HIV programmes in Myanmar; active case finding and diagnosis delay; and the final results from the STREAM stage 1 clinical trial.
The Union launched the Child and Adolescent TB Centre of Excellence in Uganda to promote collaboration and learning across the Africa region and prevent needless child and adolescent TB deaths.
With this initiative, The Union aims to create a virtual network of TB professionals and organisations across Africa, offering technical leadership, capacity building and funding opportunities to improve child and adolescent TB research and practice.
An estimated 1.12 million children under 15 years of age developed TB in 2018. The TB diagnosis and reporting gap remains unacceptably high across all age groups approaching 33% globally.
The Union’s Project Axshya, a long-running multi-sectoral TB response continued to provide innovative interventions targeted towards traditionally hard-to-reach and at-risk populations in India. Supported by the Global Fund since 2010, Project Axshya has established a network of 15,000 community volunteers mobilised to provide support and help connect people to services across the country, initiated fast-track interventions in 121 over-burdened district hospitals and held more than 150,000 community meetings providing TB awareness and information to 2.5 million people.
In the lead up to the Global Fund’s Sixth Replenishment Conference in October 2019, The Union and the Global Fund coordinated an outreach effort, bringing journalists from international media to visit Project Axshya, as a model for people-centred solutions to challenges posed by the TB epidemic.
Concluding his last General Assembly as The Union President, Dr Chakaya welcomed Professor Guy Marks as the incoming President.
At the closing ceremony of the 50th Union World Conference on Lung Health, Prof Marks paid tribute to his predecessors and spoke about the need to build The Union’s reputation as the leading voice on TB and lung disease, and his desire to grow The Union’s membership and strengthen both conferences and journals.
“It is an immense privilege to serve as President of our remarkable organisation, and to contribute in this new capacity to the effort to tackle the problem of TB and lung disease worldwide.”
The Union launched a new open access online course in TB prevention entitled Prevent Tuberculosis: Management of TB Infection. The course is designed for national TB and AIDS programme staff and clinicians to support the improvement of TB preventive care for people at risk of developing TB disease.
Ensuring people have access to diagnosis and appropriate care at the earliest stage after exposure to TB is critical to reducing TB transmission and ending the epidemic. It is with this in mind that the TB prevention course aims to better equip healthcare workers to confront the TB epidemic before causing illness and harm to anyone.
The course is available online in English. French and Spanish versions will be available in 2020.
The Union’s Survivors Summit brought together dozens of survivors of TB and lung disease, who met to discuss ways to harness the power of the community and create a more coordinated global advocacy movement. Survivors shared their personal experiences and discussed the most pressing challenges facing people with TB and lung disease in their regions.
The conference hosted many TB survivors and advocates like Nandita Venkatesan, keynote speaker at the opening ceremony, who called for urgent action to improve and shorten treatment programmes, and to place people with lived experience of TB at the centre of policy-making discussions. Her call for “nothing about us, without us” was a theme that ran throughout the week’s events.
The first International Post-TB Symposium took place at Stellenbosch University, South Africa, with The Union’s working group for post-TB chronic respiratory disorders playing a key role in its establishment and operation. The two-day event attracted 65 invited delegates from around the world.
The symposium advocated for people suffering with post-TB complications, facilitating face-to-face networking between leaders in the field, defining the current state of knowledge surrounding post-TB disease, and achieving consensus on important aspects of post-TB lung diseases. Future priority research needs were also identified, and a reference document was produced for researchers and workers in the field.
A new target addressing quality of life post-treatment was recently proposed in a Union article in the IJTLD.
On World TB Day, 24 March, Union members and staff united across the globe under the theme ‘It’s Time to End TB’.
Staff from The Union Office in Myanmar took a series of photos and shared them widely to raise awareness around TB eradication. In Zimbabwe, The Union held a community discussion forum with local and traditional leaders to make them more aware of TB. They also organised a media field trip.
To mark the day, Executive Director José Luis Castro, said: “It’s time for a breakthrough in TB”. He referred to the publication of The Lancet Commission with its roadmap setting out five priority investments, as “laying out the steps to bring about the breakthroughs we are waiting for.”
In the lead up to World TB Day, The Union hosted a panel discussion in New Delhi on the challenge of ending the TB emergency in India and globally.
The Union launched a new project, ‘Contributing to the Elimination of Tuberculosis in Africa (CETA)’, which aims to eliminate TB in Francophone Africa by 2035.
The project will support national TB programmes (NTPs) in eight countries with TB screening and prevention, improving healthcare delivery by better integrating it into the wider health system, and strengthening the governance of these NTPs.
The project builds on The Union’s many years of work supporting TB efforts in the African content and a history of close collaboration with the eight countries covered by CETA: Benin, Burkina Faso, Cameroon, Guinea, Central African Republic, Niger, Senegal and Togo.
The Union’s Global Implementation Programme, funded by Bloomberg Philanthropies, officially launched in its first two cities, Yogyakarta and Depok City, Indonesia.
At the launch events, Yogyakarta and Depok City Mayors publicly committed to improve the implementation of smokefree laws, as well as implementation of point of sale tobacco advertising, promotion and sponsorship bans in Depok City.
The Global Implementation Programme will soon launch in cities in China, India and Pakistan, and will provide technical assistance and capacity building at the city level to effectively implement evidence-based tobacco control policies and de-normalise tobacco use.
In Hyderabad, a smokefree initiative was also launched in the lead up to the Union World Conference.
The Union’s members are affiliated by region, and they work together to organise region conferences on TB, lung health and related topics. These scientific conferences brought together regional and international TB advocates, survivors, scientists, clinicians and programme managers to hear about the latest on TB diagnostics, drugs, treatment, prevention and clinical trials.
In Manila, hundreds of delegates from across the Asia Pacific region attended the conference under the theme Unity in Diversity: One Against Tuberculosis and Other Lung Diseases, while the conference in Panama focused on Prevention, People and Partnerships. In February 2019 in Vancouver delegates convened on the topic of ending TB, following conversations around the United Nations High-Level Meeting on TB in New York in September 2018, which culminated in a political declaration committed to ending TB by 2030.
The Union’s Integrated HIV Care (IHC) programme started HIV prevention activities in fourteen townships in Myanmar, targeting mixed-status couples. Community volunteers assist with the prevention activities, which include index testing which is a focused activity in which the household, family members (including children) and partners of people diagnosed with HIV are offered HIV testing services.
The community volunteers, many who are living with HIV themselves, work with the IHC team to provide counselling and testing services.
During the year, The Union in Myanmar also supported World AIDS Day by showcasing the impact of its work for the theme ‘Communities make the difference’, and hosted its annual fun day for children living with HIV under the IHC Programme.
The 4th Asia Pacific Cities Alliance for Tobacco Control and non-communicable disease (NCD) Prevention (APCAT) Summit provided a platform for knowledge exchange and the sharing of best practice and actions to combat the tobacco epidemic in the region.
Held on 25-26 September in Bogor, Indonesia, APCAT recognised its host city as the first city in Indonesia to implement a smoking ban in public places and a ban on tobacco product displays at point-of-sale.
In many countries in Asia Pacific, however, tobacco control laws are poorly enforced.
“Tobacco control is a political choice,” said Dr Tara Singh Bam, Deputy Director for The Union Asia Pacific Office. “Strong subnational leadership will ensure effective measures of tobacco control by identifying local solutions to local problems in the region.”
On World Lung Day 2019, The Union, as part of the Forum of International Respiratory Societies, called for all countries to adopt the World Health Organization’s air quality standards to reduce ambient, indoor and occupational air pollution.
The human cost of air pollution is significant, as it is a critical risk factor for NCDs, causing respiratory illness like asthma, chronic obstructive pulmonary disease, allergies, emphysema and lung cancer, with children especially vulnerable.
With 91 percent of people worldwide breathing unhealthy air, resulting in about seven million deaths annually, there is an urgent need for action and countries must do more to put in place long-term solutions that protect people from air pollution.
Reductions in air pollution can yield fast and dramatic impacts on health, as demonstrated in the research paper, Health Benefits of Air Pollution Reduction.
Management of Tuberculosis, also known as ‘The Orange Guide’ for its recognisable orange cover, was first published in 1986. Widely used reference for health workers worldwide, this is The Union’s most popular and widely used publication, with more than 50,000 copies printed in five languages. Each new revision reflects the changing dynamics of the TB epidemic and the evolving methods for TB management.
This latest edition, launched during a press conference at the 50th Union World Conference on Lung Health, includes new information on bacteriological diagnosis of TB, management of people with tuberculous infection, co-management of people with TB and selected comorbidities, such as HIV infection, diabetes mellitus and tobacco use. The guide also contains a chapter on the treatment of drug-resistant TB and prevention of TB.
“Strong and well-functioning national TB responses are essential to drive TB elimination efforts and to coordinate multi-sectoral engagement across relevant stakeholder groups. This resource provides the technical guidance to support that effort”, said Dr Riitta Dlodlo, Senior Advisor to The Union, who coordinated the development of this edition.
Photo credits: Steve Forrest, Will Boase, Javier Galeano, Marcus Rose, The Union Office in Myanmar, The Union Asia Pacific Office, and The Union North America Region