World leaders have committed to defeat tuberculosis (TB), the leading infectious disease killer in the world that infected over 10 million people last year alone – more people than live in the entire country of Sweden. Few are better positioned to ensure this happens than Dr. Lucica Ditiu, the Executive Director of the Stop TB Partnership. As a physician who has dedicated her entire career to improving the lives of those most affected by TB, the Romanian-born doctor, researcher, and advocate leads this global partnership of over 1,600 partners committed to a world without tuberculosis.
Ahead of World TB Day, which is marked annually on March 24, I sat down with Dr. Lucica Ditiu as she passionately explained how she got into public health and TB work, bust dangerous myths about the disease and suggests opportunities for advocates and governments alike moving forward in the disease response:
What specifically drew you to work solely on tuberculosis?
There is one thing about TB that made me seriously consider it: It is the fact that it affects people that are not visible. It is a disease that is spread through air, so we all can be sick. But the biggest majority are those that don’t really have a voice, so you feel like, “I would like to speak for them.” I’m speaking of the poor people, people in remote areas, those that are in one way or another vulnerable. I come from a very basic, simple Romanian family—so I know what this means, when you have to go to a doctor and they don’t even pay attention to you and your disease.
And then I think I actually like very much the numbers. It’s a very logical disease. You start the treatment, in two months you see what’s happened, at four months, at six months, then at six months you have evaluations; it’s finished, go. So it made a lot of sense and I liked it very much. But unfortunately for us, it’s still a very misunderstood disease; we know really little about it even now.
What are some things that people don’t understand about the disease?
One is this myth, you know, a lot of people don’t think TB exists anymore. Two billion people in the world are infected with TB; they are not sick, but it means they carry it. People don’t realize that TB today kills more than HIV and malaria together, because it kills slowly. If we get it and we don’t treat it, we don’t die suddenly. We die over a longer time period, and while we are sick and not treated, we infect a lot of others around us—it’s a disaster, but we don’t die immediately. So people don’t know that there still is TB and that it’s this huge burden.
The other myth is people think TB is not their problem, as it is not in their own countries. You can say, “Oh, I don’t care, I live in Washington, D.C., I don’t care.” But it’s airborne, it travels and spreads through air, so anyone is at risk. We don’t really know the real amount of time between when a TB-infected person coughs around you and when you get infected. We used to think it was a month or three weeks; now we have data from several studies showing it can be as little as hours to get infected.
The third myth I want to underline is about the vaccine. You see, there is a TB vaccine, called BCG. I was vaccinated at birth. But the vaccine does not provide protection to anyone over 5-8 years of age. And even for young children it only provides some protection against the most complicated and extensive forms of TB, like TB meningitis.
We have members who are really interested in some of our other infectious disease issues that we care about, like HIV and malaria. And a lot of people don’t know thatthat people living with HIV (PLHIV) are 19 times more likely to fall ill with TB than those without HIV.
In fact, globally, 10-12% of all those with TB are PLHIV. However, in some African countries, the co-infection rate is as high as 80%. In these countries, where you have this kind of co-infection rate, progress cannot be made on HIV/AIDS without pushing against TB . Sadly, people live with HIV now, and they are killed by TB.
How do we build excitement around this issue and what are some things that we can do moving forward, to kind of highlight the importance of TB and the threat it sort of poses?
So there are a few things that we can do. On the excitement, there are some opportunities that we have right now to finally go somewhere with greater political commitment. We have this UN high Level Meeting proposed and planned for 2018, for which Stop TB partnership and especially our chair and vice chair started the movement. We also finally see some great Indian leadership with Prime Minister Modi calling for India to end TB by 2025.
We at the Stop TB Partnership work very hard toward ensuring TB rises high on the comprehensive global agendas and conversations. And, in the Secretariat we have two other teams providing anti-TB medicines, diagnostics for TB as well as technical support for procurement and supply. And we have another team, TB Reach, funded by the Canadian government, with additional funding from the Gates Foundation, to fund, encourage and support innovative ways to find the missing cases.
I think anyone can help and be part of a global effort and movement to get rid of TB. ONE members can be of tremendous help to us, even if for only amplifying the TB messages. It is important that you all are aware of TB and what a health crisis it represents today. I keep saying that even if I speak with only five people in a room, it doesn’t matter, because now we’ll have five more people who know about TB and its risks.