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The Director's Corner

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“Before we can eliminate TB, we have to first eliminate the gaps in funding”

 A message from José Luis Castro, Executive Director, The Union

If we are to end the global tuberculosis (TB) epidemic by 2030, then significant investment into better TB prevention, diagnostic and treatment options is non-negotiable.

The problem is well documented. The World Health Organization (WHO) estimates that there were 10.4 million new active TB cases in 2016 – but only six million were diagnosed and notified. Drug-resistant TB (DR-TB) infections were on the rise, accounting for 600,000 of new cases. Yet only one in five people needing treatment for DR-TB, actually received it. And only half of those who began treatment for DR-TB, survived the disease.

The urgent need for better, more efficient drugs, a new vaccine and the technologies to aid TB detection and diagnosis is a challenge for all sectors – not just health. The impact of TB has implications for global economies, transport, nutrition, poverty, housing and more.

But TB continues to lag behind when it comes to attracting investment. The WHO estimates that research and development (R&D) budgets for TB currently have a funding gap of US$1.2 billion per year. That is the figure needed to develop new tools to aid the drug development that will stop TB in its tracks.

But from whose pockets? That TB is chronically under-funded is not news. But it is incumbent upon the TB community to make the argument that the disease is far costlier than the R&D investment needed to curtail it – the detriment to economies, broken health systems, human lives and their communities is incalculable.

In 2018, there are several moments to communicate this message and harness the support of governments to take the necessary action, culminating in the inaugural United Nations’ High Level Meeting (UN HLM) on TB in September.

This week (from 20 February), The 5th Global Forum on TB Vaccines meets in New Delhi and will demonstrate, through research, science and innovative approaches, what is possible in TB vaccine R&D. The end goal of developing and deploying new, effective TB vaccines to replace the current option* (which is over 80 years old and, at best, only moderately effective in certain situations) is genuinely exciting. But deployment is key and progress needs to happen urgently to impact those terrible TB statistics. Adequate, sustainable resources combined with scientific know-how and innovation will deliver life-changing possibilities, with added value for global economies and societies. That is hard for governments to make the case against.

Treatment Action Group’s (TAG) report released at the end of last year – The Ascent Begins - Tuberculosis Funding Trends  – called on countries to “include actions to remove impediments to research at the country level and efforts to coordinate and raise money for TB R&D through the creation of new, collaborative platforms and mechanisms on the international level.”

The Life Prize (formerly the 3P Project) is one such response and aims to incentivise investment in TB drug development, by creating an open, collaborative research framework with quality, accessibility and affordability at its core. The Life Prize is open to all - from private and pharmaceutical companies to academic and research groups—and promotes the collaboration and partnerships necessary to develop the treatments of the future and ensure maximum accessibility.

The gaps are not in the ideas or science. The gaps are in sustained and adequate funding, which need addressing before we can eliminate TB. TB is a curable disease – it is not acceptable that it continues to kill because investment falls short. Countries attending the UN HLM on TB have an opportunity to commit to funding the R&D that will end TB once and for all. 1.7 million lives depend on it.

*The bacille Calmette-Guérin (BCG) vaccine has existed for over 80 years. Read more: The BCG Vaccine - World Health Organization