The Director’s Corner
The New Year is a time to look forward to challenges ahead and to reflect on progress made in the previous year. The remarkable achievements of 2016 were testament to our staff and membership who deliver The Union’s life-changing work…
A new year’s message from José Luis Castro, Executive Director, The Union.
It is a huge challenge to review the past year and do justice to The Union’s myriad parts and as such this is only a snapshot of our global endeavours in 2016. But overall it was a year remarkable for substantial progress towards achieving our goals and positively impacting those communities we aim to support.
One of the year’s most significant developments was the announcement in May, after more than a decade of work from The Union, that the World Health Organization (WHO) was endorsing a shortened treatment regimen for multidrug-resistant tuberculosis (MDR-TB), from 24 months to just nine. This is a game-changer in global public healthcare. The Union and its partners played a crucial role in delivering the scientific evidence behind these new guidelines and their impact on the onerous burden for patients and healthcare systems alike cannot be over-stated.
Our goal is to reduce the length of MDR-TB treatment further still. The STREAM clinical trial, aimed at delivering shorter, safer treatment regimens, fully accessible to those who need them most, continues to enrol patients in three countries and will seek to work in another seven from next year. When complete, this trial could reduce a standardised course of MDR-TB treatment to just six months.
It was also the year that tuberculosis (TB) received due prominence at some of the world’s foremost public health and advocacy events.
In Durban in July, The Union was central to TB2016, an inaugural two-day conference held in conjunction with The International AIDS Society’s major convention, AIDS2016. I stated in my opening address at that event that this was a huge step towards implementing an international integrated approach to HIV and TB – two epidemics that have to be fought concurrently if we are to end them both. The recognition of TB on political agendas everywhere was no longer optional.
Community solutions are a vital element of The Union’s TB-HIV work and this is particularly evident in Myanmar. Through its integrated HIV Care Programme, last year The Union’s office provided antiretroviral therapy to 25,970 adults and children. This is over 22% of all cases in Myanmar.
2016 was the year that the world woke up to the malignant threat of drug resistance. At the 69th World Health Assembly in Geneva, The Union hosted a side meeting on this issue with partner, Medicines Patent Pool. This event brought together over 100 participants from the United Nations (UN), world governments and non-governmental organisations and focused on the critical need to address antimicrobial resistance (AMR) and its role in MDR-TB. We underlined this message when later in the year I represented The Union at the UN General Assembly meeting on AMR – a meeting that committed to increasing surveillance of the AMR threat and building capacity and investment within health systems to combat it. This is only the fourth time that the UN has held a General Assembly meeting on a health issue. That it should be on AMR has major – and welcome – implications for the seriousness in which MDR-TB is viewed. A further meeting is scheduled for 2017. Thirty percent of AMR is directly due to MDR-TB – this statistic alone is one reason why we at The Union will continue to raise the issue of AMR at every public opportunity.
At the 47th Union World Conference on Lung Health in Liverpool, UK – an event that attracted over 3,000 participants - The Union launched a dedicated MDR-TB programme, set up to provide practical and experience-based support to those countries implementing the nine-month regimen. I have said many times that supporting healthcare systems in low- and middle-income countries to access and develop impactful treatment regimens for their communities is critical. Healthcare is multi-faceted - and effective healthcare systems are rooted in practicalities, logistics and people being equipped to do the essential work on the ground. The Union’s MDR-TB programme will be both a support mechanism and a practical resource in the months ahead, when swift implementation of the WHO’s new guidelines is crucial.
Of course, raising awareness and ensuring TB, MDR-TB and its particularly pernicious version, extensively drug-resistant (XDR) TB, is front of mind is not something that ‘just happens’. It is aided by strategic media relations work that briefs the world’s media on pressing health issues and demonstrates the day-to-day impact on communities. The Union is proud of its record in hosting field trips to some of the world’s worst affected regions – and makes headlines of the health issues they face. On World TB Day on 24 March, The Union enabled a group of international journalists to visit some of Project Axshya’s community engagement activities in India’s Sonepat region. Project Axshya – meaning ‘Free of TB – plays a major role in extending TB care to isolated communities across India, the country with the world’s highest TB burden. News and video coverage of the trip was broadcast via global news agency, Agence France Presse, with syndication across 100 media outlets.
2016 was a year where historic outcomes featured strongly. Uruguay won a six-year legal battle against one of the tobacco industry’s most high-profile corporations – Philip Morris – and dealt a major blow to the attempts by that industry to delay public protection measures and undermine the efforts of under-funded countries to protect their citizens. This court case has international ramifications for tobacco control and sets a legal precedent supporting plain packaging and other public health policies that underline efforts to control tobacco and the industry that pushes it without conscience. The Union has supported the government of Uruguay through this process and will continue to provide support as it moves to implement plain packaging. Our Tobacco Control Department, based in Edinburgh, UK, produces the most up-to-date research and tools to aid poor countries take on powerful adversaries such as this one. 2016 saw the publication of an Index of Tobacco Control Sustainability. This comprehensive resource measures the sustainability of tobacco control programmes from those 24 countries with the world’s highest tobacco burden and is free to download.
Download: Index of Tobacco Control Sustainability (PDF 708 KB)
Last year also saw a change of Union President when Dr E Jane Carter ended her term – she is succeeded by Dr Muhwa Jeremiah Chakaya. In her five-year term as President, Jane has worked tirelessly on behalf of Union membership, including orchestrating the most fundamental changes to its structure in our 96-year history. At the General Assembly, held during The Union World Conference, an 18-month review and consultation process concluded with the adoption of the changes to the membership structure. She also presided over three of the largest World Lung Conferences in the Union’s history bringing attention to the issues of TB and diabetes, TB in prisons and zoonotic TB. I look forward to working with Dr Chakaya as he makes these changes felt for years to come.
The Union’s influence is too vast, too extensive, to mention every single accomplishment. In 2016, The Union continued to implement life-saving programmes, treat and advocate for patients, conduct research, convene conferences and work towards our goal of finding – and implementing – solutions. The range and scope is testament to the individual officers, managers, members, health workers and clinicians who deliver this work – and deliver change that makes critical difference in the quality of life for so many. Our impact in the year ahead depends on it continuing.
Thank you all for your astonishing contributions.
Watch The Union’s slide show of some images that best capture our work in 2016