How to avoid stagnating the fight against tuberculosis

David Bryden, Stop TB Advocacy Officer at RESULTS, shares new tuberculosis findings.

“It would be a fatal mistake to ignore tuberculosis,” declared Dr. Mario Raviglione, Director of the WHO’s Stop TB Department, at a press conference yesterday in Washington, D.C., where he and a panel of experts released a new report on the state of the tuberculosis (TB) epidemic.

Dr. Raviglione cited impressive successes fighting TB, but he also warned that the response to the epidemic is “at a crossroads.”  He said we can either push on to conquer the disease, using some exciting technological innovations, or we can allow our efforts to stagnate.

“An optimist can even see TB elimination on the horizon in some countries, so we must not break the momentum we have on tuberculosis,” stated Dr. Raviglione.

Tuberculosis is a bacterial infection which is spread by the simple act of coughing, and it kills 1.4 million people a year, nearly as many as HIV/AIDS. TB kills one out of four AIDS patients, and it can provoke even more stigma and fear than HIV, since it is more easily transmitted than HIV.

The essential facts on TB are captured in a bold, new brochure published today by the Stop TB Partnership and WHO. There is a $1.4 billion funding gap per year for research and development for better drugs, vaccines and diagnostic tools.  Plus, despite the impressive results from Global Fund support for tuberculosis programs, there is a $3 billion per year funding shortfall between 2013 and 2015, with poor countries most at risk.

“If we stay on the current course, we are certain to see the widespread emergence of incurable TB strains,” said Kolleen Bouchane, Executive Director of ACTION in a press statement.

“TB knows no borders and it would be very dangerous to let our guard down,” stated Dr Kenneth Castro, Director, Division of TB Elimination, National Centre for HIV, STD and TB, Centers for Disease Control and Prevention (CDC) at today’s event.  He highlighted the case of a young American volunteer from Tennessee, Natalie Skipper, who picked up drug resistant TB in South Africa and who recently told the story of her own harrowing battle against TB at a briefing in the US Congress, co-sponsored by the House TB Elimination Caucus and the HIV/AIDS Caucus.

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Natalie Skipper, a volunteer from Tennessee who says she is still eager to return to Africa to serve the community
But there are some signs of hope cited by the WHO report.  One is that new drugs are on the horizon, which would dramatically shorten the course of treatment.  WHO stated yesterday that two new medications will be coming out next year, plus there promising vaccine candidates in development.  Dr. Castro underscored the importance of intensifying the investment in research and development, in order to move, as he said, from “using chisels and hammers to using power tools against TB.”

Another hopeful sign we see is that the heads of state of fifteen countries in southern Africa recently issued a far-reaching declaration laying out a coordinated approach to end TB and HIV in the mining industry, plus the strong interest expressed by the new head of the World Bank, Dr. Jim Kim, in this issue.  A whopping one-third of the tuberculosis cases in sub-Saharan Africa are linked to the mining industry.

And finally, TB programs are engaging in smarter ways with the community, as in South Africa where the government is screening people for TB and HIV in their own homes.   Patients, including those in remote, rural areas, should not have to navigate a maze to get care, or face ostracism — a point made in the Stop TB Partnership’s recent Talk Show on women, children and TB-HIV.

TB is catching the interest of policy makers and this WHO report is a crucial new tool to help educate and inspire.  Have you asked your member of the House of Representatives to join the TB Caucus?  This report is a great opening to reach out to them on TB.