On World TB Day, the Forum of International Respiratory Societies calls on the United Nations General Assembly to commit to the urgent changes needed to end TB, in their first High-Level Meeting (HLM) on TB.
Forum of International Respiratory Societies calls on governments for political commitment and action to end TB
On World TB Day, the Forum of International Respiratory Societies (FIRS) calls on the United Nations (UN) General Assembly to commit to the urgent changes needed to end tuberculosis (TB), in their first High Level Meeting (HLM) on TB.
FIRS urges governments to ensure that their national response to TB is adequately funded and that national plans are implemented. In particular, we call on governments to support significant investment to improve TB prevention, diagnostic and treatment options so that the global TB epidemic will be eliminated by the End TB deadline in 2030.
TB is preventable and curable, yet it remains the world’s most common infectious disease killer. 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 received it. And only half of those who began treatment for DR-TB, survived the disease.
Despite the scale of the problem, TB continues to be chronically under-funded. The WHO estimates that research and development (R&D) budgets for TB currently have a funding gap of US$1.2 billion per year. In a year that will see the first-ever UN HLM on TB, this gap is untenable and must be addressed as a matter of urgency.
“TB is the world’s most common infectious disease killer yet is identifiable, treatable and preventable; what is missing is the political will to dedicate the resources necessary to eradicate it, once and for all,” said Dean E. Schraufnagel MD, Executive Director, FIRS
FIRS is calling for the following points to be adopted at the UN HLM on TB and be enshrined in the declaration from that meeting, so that progress in combatting this deadly disease is accelerated:
- Sufficient and sustained investment to address TB funding gap. In 2016, 1.7 million people lost their lives to TB – a curable disease. The R&D budget for TB must see long-term investment commitments if essential new tools and vaccines to replace outmoded versions are to be developed and deployed. The WHO says that closing the TB funding gap will require more resources from both national domestic budgets (especially from middle-income countries) and from international donor sources to support low-income countries.
- A multi-sectoral approach. TB is a societal issue that has implications beyond the confines of a purely health-led response. It is devastating to economies, infrastructures and communities, as well as putting untold pressures on already under-resourced healthcare systems and their staff. For TB to be eradicated, it is essential we demonstrate its relevance to every single ministry and government department. Only then will countries realistically step up their engagement and investment into combatting TB.
- Investment in active case finding to find the missing ‘millions’. In 2016, 6.3 million new cases of TB were reported, equivalent to only 61 percent of the actual TB burden (estimated to be in the region of 10.4 million). Without investment in active case finding, the missing millions already ill with TB will remain untreated, contributing not only to mortality but also to ongoing transmission and to the next generation of TB cases.
- Childhood TB recognised as an epidemic in its own right. Childhood TB remains an uncontrolled epidemic. An estimated one million children fall sick to TB annually but only one in three children with TB is diagnosed, much less treated. Without treatment, 22 percent of children with TB under 15 years of age and 44 percent of children under five will die. But 99 percent of children with TB who receive treatment survive. Paediatric TB must be prioritised for both scientific advances such as clinical trials, but also programmatic care targeted at their special risk.
- Promote a global and integrated approach to addressing TB in migrants. Between 1970 and 2017, the number of international migrants increased from 82 million to approximately 244 million – that’s three percent of the world’s population – and poses additional and complex challenges to the End TB strategy for all countries. With migrating populations now the norm, the UN HLM on TB must make provision for these under-served populations and ensure that health inequalities, such access to care and treatment, are addressed.
Notes:
All quoted TB statistics are from the Global Tuberculosis Report 2017, The World Health Organization
Figures relating to international migration courtesy of The History of Global Migration Governance by Alexander Betts and Lena Kainz; Refugee Studies Centre; Oxford Department of International Development: University of Oxford. July 2017
About the Forum of International Respiratory Societies (FIRS):
The Forum of International Respiratory Societies (FIRS) is an organization comprised of the world's leading international respiratory societies working together to improve lung health globally: American Thoracic Society, American College of Chest Physicians, Association Latino Americana De Thorax, Asian Pacific Society of Respirology, European Respiratory Society, the International Union Against Tuberculosis and Lung Disease, Pan African Thoracic Society, The Global Initiative for Chronic Obstructive Lung Disease, and the Global Initiative for Asthma. The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.
About the United Nations’ High Level Meeting on TB:
The UN HLM on TB will be the fifth time the UN has called for a HLM devoted to a health issue but only the first-ever dedicated HLM on TB. The main outcome of the UN HLM on TB will be a Ministerial Declaration which is negotiated by two representatives of the Member States.
The meeting will be held in New York on 26 September 2018.