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The Director's Corner

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It’s time for a breakthrough in TB. The Lancet Commission report, published this week, provides a roadmap for just that.

A message from Executive Director José Luis Castro on World TB Day, 24 March 2019

Reading the news of the second person to be cured of HIV, I felt a renewed sense of hope at hearing the announcement of this breakthrough. It’s moments such as this that show us all that it is possible, that we are capable of huge advancements against a disease that just thirty years ago was deadly and untreatable.

While this milestone in the AIDS epidemic is far from the end, breakthroughs like this are as necessary for scientific advancement as they are for our morale. It feeds our determination to push forward despite great obstacles.

These moments have accompanied us through the fight against tuberculosis (TB) as well.

The development of the BCG vaccine, the discovery of Streptomycin and other antibiotics that brought about the first treatment regimen to cure TB, rapid diagnostics that distinguish drug-resistant strains in a matter of hours, improved and shortened treatment regimens with less severe side effects – these are just a few examples that come to mind.

And this past September, when world leaders convened at the United Nations High-Level Meeting (UN HLM) on TB and endorsed the first-ever political declaration containing concrete commitments to measurable TB elimination targets, I felt the excitement of being on the verge of some enormous shift.

I think we all experienced that moment as pivotal – that the scene is set for decisive action that has the potential to bring about groundbreaking advancements.

Now, with the publication of The Lancet Commission just prior to World TB Day, we are provided with a roadmap that lays out the steps to bring about the breakthroughs we are waiting for.

Drawing on the experience and expertise of 37 TB experts from 13 countries, the report sets out five priority investments to achieve a TB-free world within a generation. These recommendations include ensuring high-quality diagnostics and treatment are available everywhere they are needed, reaching high-risk populations and facilitating their access to TB screening and prevention, increasing investments in research and development (R&D), investing in TB as a shared responsibility, and holding countries and stakeholders accountable.               

Through these five recommendations, the report divides up the TB response to focus first on scaling up existing interventions to ensure that high-quality tests and treatment are easily accessible everywhere they are needed and to target high-risk groups such as people living with HIV and children with preventive treatment.

Second, investment into TB R&D must be increased. The report shows that investing in R&D for TB has a strong return on investment, with an estimated US$ 16-82 return for every dollar spent. Similarly, the economic benefit to high burden countries is significant, with savings from averting a TB death estimated to be three times the cost of treatment, and likely to be even higher in many countries.

And finally, by establishing a mechanism for accountability, we will be able to hold governments to their word and evaluate and revise our response to TB to ensure we are moving in the right direction. By taking on this responsibility as a global community, we place the burden on no one government or entity alone but promise to share the TB response as an issue of global importance.

With the launch of the TB Observatory, an independent annual evaluation on the progress made by countries in meeting the targets outlined in the political declaration on TB, we can measure our success and quantify our progress. Led by the commissioners of this report, this tool will enable us to ensure the promises made at the UN HLM on TB translate into actions – and lives saved.

This year’s theme for World TB Day is ‘It’s Time’. I can think of no more fitting a theme for this year as we as a community stand ready for the next great step.

It’s time for a breakthrough. It’s time to end TB.