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The Director's Corner

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"TB is a societal issue. If it is to be eradicated, we must demonstrate its relevance to every single ministry and government department." 

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

This week the Executive Board of the World Health Organization has been meeting in Geneva to determine the contents of the 71st World Health Assembly (WHA), 21-26 May.  For those of us in the tuberculosis (TB) community, this meeting of the WHA is critical. In a year when we are preparing for the first-ever United Nations’ High Level Meeting (UN HLM) on TB, it is surely non-negotiable that TB must also be a significant part of the WHA agenda.

TB is the leading infectious disease killer worldwide. Latest figures* state that the disease kills 1.7 million people annually (including almost 400,000 people with HIV-associated TB) and 10.4 million people fall ill from TB (with 600,000 of these new cases being drug-resistant). As we move swiftly towards the End TB deadline in 2030 - the date by which the world has pledged to eliminate TB - the reality is that progress has stalled, due, in part, to under-investment in research and development and lack of political engagement.

As I said in The Lancet Infectious Diseases earlier this month, the world has committed to eradicating TB by 2030, but without something new, we won’t make that. If we continue with the tools we have, it will be 100 years before we deal with TB.

To quote the WHO, The End TB Strategy rests on three pillars: “integrated, patient-centred care and prevention; bold policies and supportive systems; and intensified research and innovation.”

But this needs sustained, concentrated funding and leadership at the highest level that will address the high costs of treatment, social stigma and lack of adequate preventative and treatment care facilities that we routinely see in poorer countries.

The UN HLM on TB is our opportunity to gain concrete commitment and advocacy from those leaders who make the policies and allocate national budgets. It is no longer enough for the TB community to talk amongst ourselves. We should go beyond the traditional approach of the ‘call to action’. In a world already anaesthetised by headline-grabbing epidemics and acts of atrocity, we must present a coherent joined-up strategy that has buy-in at the highest level. And we must present an argument that resonates not just within health sectors but far wider. TB is a societal issue. It is devastating to economies, infrastructures and communities. For TB to be eradicated, it is essential we demonstrate its relevance to every single ministry and government department. 

By giving TB due prominence on the agenda for the WHA, we are drawing a line in the sand by highlighting to both global and national institutions that TB is a priority – and we can begin to highlight the issues and formulate the arguments that must be addressed at the UN HLM.

This year offers major opportunities for our community to advocate for the changes that need to happen. This will require difficult conversations, where we tell governments and heads of states that what they are currently doing to fight TB isn’t enough. None of us will live to see the elimination of TB, if they do not actively generate tangible, sustainable resources, invested in new drug development and universal healthcare access. This is beyond politics. Until we get these commitments, TB will continue to ravage our world.

*Latest figures: WHO Global Tuberculosis Report 2017