The Debate

Time to End Tuberculosis in Asia – and the World

The drive to end TB has reached a tipping point. Here’s how it can be accelerated.

Time to End Tuberculosis in Asia – and the World
Credit: Samuel Zeller on Unsplash

The drive to end tuberculosis (TB) as a public health threat by 2030 has reached a tipping point. In much of the Global North – despite rising caseloads in some countries – TB has, for many years, been considered a vestige of times past. But its catastrophic impact on health and wellbeing in developing countries – as well as its devastating effect on socioeconomic development – has too often been ignored or underprioritized.

That is unacceptable. More than 1.7 million TB-related deaths are registered annually, including almost 800,000 in the World Health Organization (WHO) Southeast Asia region alone. Every year, millions of people in TB-affected countries are condemned to vicious, life-defining poverty, while the productivity of whole economies is stymied by TB’s brutal, life-sapping burden.

This need no longer be the case. Or at least not if momentum to end TB by 2030 – as per the Sustainable Development Goal target – progresses, as it must.

As it is.

So why the tipping point?

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Start with political will. In TB-affected countries, including those of the Southeast Asian region, domestic funding for TB programs has increased dramatically. In some countries – such as India – it has trebled. Active case-finding has meanwhile become a core focus, especially among high-risk groups. Patient-centered policies such as direct cash transfers and nutritional support for persons suffering TB have been implemented, while civil society organizations have been actively engaged and included in programmatic decision-making. These initiatives are having immediate, game-changing impact.

That political will was reinforced this week, when, at a TB summit in New Delhi, India, ministers of health and representatives of the WHO Southeast Asia Region – the world’s most TB-affected region – developed and adopted a Statement of Action – a manifesto that will intensify momentum to end TB’s unconscionable burden, both in the region and across the world.

Beyond expressing the resolve and high-level commitment needed to combat TB effectively, that Statement outlines a series of strategic imperatives that will change the lives of TB sufferers region-wide, from the dust-choked alleys of urban slums to hard-to-reach and remote areas where TB services can be thin on the ground.

To date, global support for national and regional initiatives has been strong. Last year’s Ministerial Conference on TB in Moscow is a good example. There, ministers of health from across the world expressed their desire to get things done – to make TB a vestige of history, exactly as it is in much of the developed world, with donors pledging to provide the resources needed to chart bold progress.

Critical to present momentum is WHO’s recently elected leader, Dr. Tedros Adhanom Ghebreyesus. He has made it his personal mission to combat, with renewed vigor, the heartbreaking afflictions that destroy the lives of millions of people across the world, with a special focus on harnessing the full power of health coverage for all. Importantly, those afflictions include TB.

But as strong as global support is, it will be tested. Not by those already invested in ending TB’s menace – from TB-affected countries, including those in the Southeast Asian region, and international partners such as the Stop TB Partnership, Global Fund, and bilateral partners such as USAID. Rather, that support will be tested by the willingness of governments and their representatives throughout the world to get on board and match national, regional, and global momentum with actionable assistance.

The kind of assistance that will allow national TB programs to act with decisive efficiency in pursuing their strategic priorities, from active case-finding to providing essential nutritional support. The kind of assistance that will fast-track research and innovation, especially with regard to rapid diagnostic technologies and antibiotics that can treat TB’s drug-resistant strains. And the kind of assistance that can help build stronger health systems that ensure all people everywhere can access the TB-related services they so desperately need.

September’s High-Level Meeting on TB, occurring alongside the UN General Assembly, is an opportune time for the global community to do just that: recognize, appreciate, and honor (via quantifiable assistance) the commitment to ending TB that has been expressed and pursued daily in TB-affected countries across the world, and which was reiterated once again in New Delhi this week.

Indeed, it is an opportune time to demonstrate the full power and potential of global health diplomacy, not only as a means of strengthening the bonds between emerging and developed economies, but of bringing real change to the lives of millions of people and, in the process, creating a healthier, more prosperous, and secure world.

The drive to end TB has reached a tipping point. Now is the time to accelerate it.

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Dr. Poonam Khetrapal Singh is the Regional Director of WHO Southeast Asia.