The Stop TB Partnership has launched a detailed strategy to finally put an end to the world's oldest pandemic.
The Global Plan to End TB 2023-2030 lists priorities and estimated funding needed to end TB as a global health threat by 2030 through early diagnosis and treatment, the development, approval and distribution of a new TB vaccine; and the redoubling of efforts so that emerging crises or conflicts do not derail TB programmes.
According to Dr. Lucica Ditiu, the executive director at the Stop TB Partnership, ending TB by 2030 is a sustainable development goal and it's our responsibility as humans to be able to end TB. She says the plan is to bring it down to a level that can be controlled - which is an average of around 10 per hundred thousand globally by 2030.
"Covid-19 was not nice to human beings, it was not nice to the TB response, and unfortunately we saw our efforts being pushed back. Due to the fact that a lot of the TB platforms, doctors, hospitals, diagnoses were transferred for Covid-19 and due to all the measures that were taking place to fight the pandemic, however, countries are making a fantastic efforts and we observe that almost everywhere, there is recovery of what was lost during Covid-19 and more than that going in full speed towards ending TB.
"To end TB we don't need only the efforts, we don't need only the attention, we need the tools and we need the resources and this global plan speaks about what is needed ... but also at what price, it has a big price tag to end TB by 2030 but also, I really invite you to take a look over the return of investment. It's a fantastic return for every single dollar invested in the TB response can go up to U.S.$40 as a return ... not only in health but in general," Ditiu says.
According to Mansukh Mandaviya, minister of health and family welfare for the government of India, TB has primarily been a disease of poverty. Developed countries are almost eliminating the disease and the real challenge is in developing countries, where due priority is still not given. It kills more than 4,100 people every day globally.
"This global plan projects that between 2023 and 2030 to reach end tuberculosis targets globally, U.S.$250 billion will be required from all sources, including governments, bilateral and multilateral donors, philanthropy, the private sectors and innovative sources of financing. It is estimated that implementing the priority actions recommended by the global plan would deliver a return of U.S$40 for every dollar invested. Delaying or failing to implement the Global Fund will result in an immense human and economic loss," says Mandaviya.
According to Dr. Paula Fujiwara, a moderator at the Global Plan Task Force, if the delineated priority actions in the global plan are adhered to, it is feasible to reduce annual TB deaths by 90% and treat 50 billion people for tuberculosis, including children and those with drug-resistant tuberculosis by 2030. She says the plan emphasises priority actions for each component of the plan - care, prevention, stakeholders and the advocacy opportunities, especially at country level. It highlights the key role of communities and the need for increased investment in their contributions.
"For the first time, this global plan highlights the call for approving a new vaccine by 2025 with a full country rollout by 2027. This will not only be a treatment intervention, but also a preventive TB prevention measure. There is going to be an emphasis on the spectrum of subclinical tuberculosis beyond the dichotomy of just having TB infection or actually full-blown TB disease and the ways, this can be addressed to identify people along the pathway," says Fujiwara.
According to Paul Mahanna, the director at the Office of Infectious Diseases, USAID, Bureau for Global Health, conflicts elsewhere in the world, including Russia's ongoing invasion of Ukraine will likely exacerbate setbacks by Covid-19 further dimming prospects of reaching the United Nations High Level Meeting on TB global targets by the end of this year.
"In the wake of these devastating impacts on global TB efforts it is critically important that, as a global community, we anticipate and plan for the actions and resources needed to end TB by 2030. We must work together across sectors including TB survivors and affected communities and mobilize political will, provide to implement innovative financing mechanisms, and increase domestic resources. This plan underscores both the financial needs to end TB and the devastating cost of inaction. We cannot drive change without addressing the significant funding gaps that exist within high TB burden countries that result in lack of access to life-saving services and drive individuals, families and communities further into poverty," says Mahanna.
"Currently, almost 30% of funding per TB case comes from out-of-pocket costs, and on average individuals with TB and their households lose 50% of their annual incomes as they suffer from and get treatment for the disease, even in places where TB services are provided free of charge. Our HIV programs have been successful at driving down out-of-pocket costs but people with TB and their families pay eight times more for their diagnosis and treatment than people living with HIV, hampering access to TB diagnosis and treatment and perpetuating poverty among the world's poorest and most marginalized populations. Addressing these financing gaps will pay off in dividends, it will drive down TB deaths and mitigate contributing co-morbidities and prevent health-driven poverty. It will scale up effective tools that can be used to prevent future airborne pandemics and it will save economies and countries impacted by TB," Mahanna says.
It's important for the Global Plan to End TB to involve civil society so that they can share their voice, their concerns, their practices, their life experience to ensure that those who have the plan can implement it fully and meet the demands on the ground, according to Choub Sok Chamreun, the Executive Director of Khmer HIV/AIDS NGO Alliance (KHANA) and Global Plan Task Force member
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Dr. Tereza Kasaeva, the WHO Director of the Global TB Programme, says her organisation is working on a STOP TB partnership to ensure that countries are implementing the End TB Strategy and the latest WHO guidelines on TB prevention and care.
Kasaeva says there is a need to invest in accelerating the uptake of the latest WHO guidelines and tools, including all oral regiments, rapid molecular tests that can significantly influence treatment outcomes and can provide really modern quality care. She says WHO is closely working with the case to stakeholders also promoting vaccines and other view to development, but that can help break the trajectory of the deadly TB epidemic.
"Building on lessons alone from Covid-19 pandemic, WHO Director General Dr Tedros Ghebreyesus has announced that we will convene a high level summit on new TB vaccine development in the coming months ... We look forward to work closely with the country's partners with the STOP TB partnership in preparations for the UN High Level Meeting which will be a second landmark in bringing together Heads of States and other leaders to re-energize commitments to end TB," says Kasaeva.
