As the world marked TB day on Friday, March 24, 2023, nations most affected by tuberculosis are now shifting focus to new efforts, research, tools, and innovations as the international community works towards ending tuberculosis (TB) by 2030.
During the World TB summit held on the same day in India, the Stop TB Partnership Board and partners called for high political commitment, ambition, hard work and a robust plan to end TB.
To ensure that the world eradicates TB by 2030, a high-level advocacy platform dubbed the Coalition of Leaders to End TB was formed during the summit.
Leading the coalition
India’s Prime Minister Narendra Modi will lead the coalition with President Joko Widodo of Indonesia, President Lula da Silva of Brazil, President Cyril Ramaphosa of South Africa, and the newly elected President of Nigeria, Bola Tinubu being members of the team.
The Coalition of Leaders will be formally launched during the United Nations (UN) General Assembly week in New York City in September 2023.
In 2022, several of the high TB burden countries—including Brazil, Nigeria, India and Indonesia—diligently increased the number of people diagnosed and enrolled in TB treatment, reaching and exceeding the numbers seen before the COVID-19 pandemic.
TB burden in numbers
According to preliminary data from the Stop TB Partnership, in 2022, the gap between the estimated number of people with TB and those diagnosed and treated was the lowest ever—with less than 3 million missing people with TB.
This gap was 3.2 million in 2019, 4.3 million in 2020, and 4.2 million in 2021.
Despite this progress, as the COVID-19 pandemic ebbed last year, TB regained its tragic title as the world’s biggest infectious disease killer due to setbacks in diagnosis and treatment over the past three years.
This year is critical as the international community prepares for the next UN High-Level Meeting (UNHLM) on TB in September 2023, the second such event held at the UN General Assembly.
“With the world regaining strength as the COVID-19 pandemic wanes, ending TB as a global health threat is a critically important goal,” said Dr. Lucica Ditiu, Executive Director, Stop TB Partnership.
“We have new innovations now to help us save lives—new diagnostic tools, shorter, less toxic treatment regimens, and new digital tools—and when we add the political muscle that the UNHLM will gather to the many dedicated health care professionals already in the front lines, ending TB looks increasingly possible,” Dr. Ditiu explained.
Ending TB
At the first UNHLM in 2018, 15 Heads of State and Heads of Government joined 1,000 participants in pledging to increase efforts to end TB.
While the COVID-19 pandemic upended many of these commitments, the upcoming UNHLM on TB has already seen momentum in bringing the world together to renew this important goal.
Experts, scientists, donors, medical workers, and advocates worldwide are already making up the ground that was lost due to the COVID-19 pandemic and economic downturn.
“It is absolutely inspirational to see so many nations stepping forward with their own national plans to end TB,” said Austin Obiefuna, Executive Director of the Afro Global Alliance in Ghana and Vice Chair of the Stop TB Partnership Board.
Obiefuna says that TB hits the poorest parts of the world hardest.
“It will not simply go away; instead we need all governments to join us in stopping this disease from wrecking people’s lives, their families and their livelihoods,” he adds.
New tools and investments
In the past few years, new tools to combat TB have cleared regulatory approvals and entered the marketplace.
Multilateral institutions and development agencies are working to make these innovations more accessible and available to the countries and regions most in need.
Some of the new innovations include:
- Rapid molecular tests that can identify TB and resistance patterns in the bacteria;
- Shorter treatment regimens for drug-sensitive and drug-resistant infections;
- New digital tools, such as AI-enabled ultraportable X-ray systems for screening for TB; and
- Vaccine candidates that have advanced to phase 3 clinical trials.
Globally, investments in TB research and development have started to climb, surpassing $1 billion for the first time ever.
Funding the fight
Advocates look to the coming UNHLM to boost this momentum and help governments and funding institutions reach the $2 billion goal pledged at the first UNHLM, and further increase to $5 billion per annum as estimated by the Global Plan to End TB.
And there is growing political momentum on commitment and ambition from countries like India, Indonesia, Nigeria and South Africa to step up action at a time when new data shows that every $1 invested in TB yields $46 in benefits.
“What we need is quite simple, given that TB kills 1.6 million people every year,” added Dr. Ditiu.
“We need increased political commitments from all high TB burden countries, and significantly more financing so that we can meet all the challenges and embark upon a much faster path to new vaccines.
We know what it takes to end TB; we need to roll up our sleeves and make it happen,” she challenged.
India’s high TB burden
According to the Stop TB Partnership, India, the country with the highest TB burden (globally), has displayed a strong ambition to beat back the disease.
In 2022, 2.4 million people with TB in India accessed diagnosis and treatment, which is the highest ever in any year and signals that India’s TB response has now fully recovered from the impacts of COVID-19.
“Under the Prime Minister’s TB Free India Campaign, launched in September 2022, nearly 1 million people with TB have received commitment from individuals in society who will support them through their treatment journey,” explained Suvanand Sahu, the Deputy Executive Director of the Stop TB Partnership.
“This initiative is unique in the world and is a great intervention for TB awareness, stigma elimination, community ownership and crowd funding,” he said.
India has a unique real-time TB information system called NIKSHAY, which is also linked to direct cash transfers to TB patients.
In the last five years, using this system, $260 million has been disbursed to nearly 8 million people with TB to support their nutrition.
The ambitious call from the Prime Minister to end TB in India has driven innovations in the areas of digital tools, diagnostics, data systems, community engagement and logistics.
Twenty-five of these innovations, developed in the last two years, will be presented at a session at the Stop TB Board meeting on March 15 in Varanasi, India.
Implementation
Ownership for implementation has been decentralized to state, district and village levels, with awards given to recognize states and districts that are making rapid progress toward ending TB.
People who have gone through the experience of TB are being empowered and made “TB Champions” for their contributions to ending TB in their community.
Currently, more than 30,000 TB Champions are supporting the TB response in India.
“India is providing models to fight TB. Trace, Test, Track, Treat and Technology is the strategy we are implementing to end TB in India by 2025. India is also producing 80% of TB medicines.
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It is determined to end TB by 2025. India is ready to work shoulder to shoulder with all other countries and ensure a better world for future generations,” added Prime Minister Modi.
