HOW TO ACCELERATE EFFORTS TO END TB BY 2030

 

BY FRANCIS OKOYE

 

In a special webinar organized on 17th March 2017 in lead up to 2017 world TB day by Citizen News Service CNS, it was  revealed that governments of more than 190 countries globally have committed to end TB by 2030 by adopting the sustainable development goals (SDGS) at UN General Assembly in Sept 2015. This commitment to end TB is in line with the WHO End TB strategy, which was adopted by world Health Assembly in 2014.

According to one of the moderators of the webinar, AshoK Ramsarup former SABC senior producer in south Africa ‘Scientist found out that many patients with resistant TB have never been treated. Most  TB/HIV patients are not treated and they die’ He therefore advocated for a multi sector response to the issue’.

Speaking during the webinar, Dr. Mario Raviglione, Director, Global TB programme of WHO on ‘Ending TB in sustainable development Era-political commitment and multi sectoral era, He said that preparation for Moscow conference which has a global commitment to end TB by 2030, with implementation started in 2016. He explained the importance of different SDGs towards ending TB, issues like poor living and working conditions, food insecurity, unhealthy behaviour-indoor air pollution, crowding, non communicable diseases, smoking, alcohol, are pathways to TB. HIV/AIDS, malnutrition . also conducive environment to transmit TB including exposure to TB, infection, active  TB, Consequences: latent infection to development-death. TB affects SDGS No 1, No 7, No 11, No 2 No 4, No 8 and No 10.

Dr. Mario said that the world TB day 2017 with focus on ‘unite to end TB-leave no one behind’ Addresses discrimination, Marginalization, stigma, overcoming barriers to access care, access to most vulnerable, addressing MDR-TB, aligned with UN SDG, call to action  to ensure access for all to quality TB care, meet needs of children, migrants, refuges and other vulnerable populations.

Undoubtedly  health and  Non health sectors both need to collaborate effectively along with other stakeholders, including affected communities to accelerate efforts to end TB by 2030 (or earlier) with this intents, potentially one of the most pivotal meeting happening this year, is the WHO global ministerial conference: Ending TB in the SDG era-a multi sectoral

Response, holding from 16 -17  Nov 2017 in Moscow, Russia.

The conference vision and multi sectoral approach,  expected outcome of multi sector  accountability according to Dr. Mario Include

  1. Universal coverage of TB care and programmes
  2. Sustainable finance ,social protection and development
  3. Respect for equity, ethics and human rights
  4. Scientific research and innovation
  5. Monitoring and evaluation of progress
  6. Action on AMR, Health security and MDR-TB
  7. TB/HIV responses
  8. Linkage and sineages we must take for community diseases. He also quoted UN Gen Assembly Resolution of 15 Dec 2016, for a high level meeting on TB in 2018, which has brought the opportunity to bring TB to heads of states of the world-an unprecedented opportunity.

In her own contribution, Dr Soumya Swaminathan, Director General of Indian council of medial research IMR and secretary of Dept of Health Research, ministry of Health and family welfare, Government of India, stated that a lot is not understood about prevention, spread and diagnosis of TB. ‘TB diagnostic expensive and not accessible to all. We need diagnostic that can reach all. Need to have bio makers, so that in other to progressive, we don’t give preventive therapy to 10 people when we should need only one in 10- we don’t have test to detect progression. Radiography-we need ICT to read larger xray. Treatment of everybody not possible, need to do drug trials, addons or adjust, need vaccine  more effective than BCG, we also needed research from Animal testing-to human and these need human and financial resources. We need to optimize service delivery-how best service can be delivered i.e in mountain area or slums? All these can help in accelerating end to TB by 2030 or earlier if adequately handled.”

She gave example of india were the Indian National Tb research foundation was set up, to bring stakeholder, NGO’s Agencies, start ups, Entrepreneurs, Scientist to involve  in research on above methods of accelerating end to TB by 2030. They completed the South East Asia ministers conference to end TB with commitment to end TB and set up fund for research. She concluded that we cannot ignore research, since we don’t have all the tools now, without  new tools, we cannot do it, not only financially but coming together of scientists.

Another expert, Paul Jensen, Director, policy and strategy International Union Against Tuberculosis and Lung Disease (the Union), and one of the persons who raised 1 billion  dollars in research for HIV/TB, was of the opinion  that we need  involvement of  many more people, that TB kills more people that any more infection in the world but is curable and not a lot of people know about it.

He said that 580,000 persons annually suffer from drug  resistant TB, one of the worse illness a person can face, life altering. Sickness-socially, physically, financial if you survive. 4 out of 5 people with TB who become drug resistant, not even diagnosed, die and spread the disease .On  the solution, Jensen revealed is the WHO recommended new regime. Each  country should use it, it is shorter than the previous one, from 2yrs to 9 months, more effective treatment and cheaper. This organization is involved  in finding shorter regime for TB, at least 1 month for TB, this depend on resources from government and other funding agencies.

Probha Mahesh, program manager with ALERT India, who has 12 yrs experience working with patient communities and mentoring TB advocates, said in the webinar, that TB disease control success depends on measures like early detection, prevention, accurate treatment and adherence to treatment. She advices health care givers to observe patients for default-identify why they will not complete treatment and then solve the problem. She also suggested family and community monitoring of treatment adherence and more emphasis on counseling and community intervention in TB care.

The other moderator for this special webinar was Shobha Shukla, CNS managing Editor.