On 26 September in New York, global leaders gathered at the first ever United Nations High-Level Meeting on Tuberculosis.

Tuberculosis (TB) knows no boarders – it affects all countries and all age groups! In the latest 2018 Global Tuberculosis Report released by World Health Organisation (WHO), burden of TB is falling worldwide but not fast enough to reach the first 2020 milestones of the End TB Strategy. In 2017, there were an estimated 10 million new cases of TB and about 1.6 million deaths were recorded.

Under the theme ‘United to end tuberculosis: An urgent global response to a global epidemic,’ this meeting served as an opportunity for Heads of State to make clear commitments to fight tuberculosis and reaching all affected people with prevention and care. In attendance of this highly anticipated meeting was Bill Gates, co-chair of Bill and Melinda Gates Foundation, who commended the need for ‘A higher degree of political leadership and more concrete actions are required’ in order to speed up progress towards 2030 goals. Over 15 Heads of State addressed the opening plenary session with nearly 80 Ministers of Health and Ministers of Foreign Affairs addressing the plenary, many from high TB-burden countries appealing the world to take note. For instance, in his speech South Africa President Cyril Ramaphosa echoed that:

Read more of the statements here

Speaking at the opening session on behalf of communities affected by TB, Nandita Venkatesan urged global leaders to back up this declaration with tangible actions. She expressed this further in her statement ‘For those that need care, scientific progress must reach all those who need it quickly,’ receiving a two-minute ovation for her powerful remarks. Significant highlights of this first-ever high-level meeting saw world leaders endorsing a UN Political Declaration on TB.  Member states agreed to nearly double global levels of TB funding to reach the target of USD13 billion per year by 2022 and to reach $2 billion in R&D funding. Apart from world leaders’ commitment to diagnosing and treating 40 million people with TB successfully and providing 30 million people with preventive treatment of TB by 2022, this political declaration factored in many of the key asks and targets launched by Stop TB Partnership and key TB stakeholders earlier this year.

Inasmuch as world leaders endorsed the political declaration, there were no commitments to a robust and independent mechanism of ensuring accountability. However, WACI Health together with other civil society and TB affected communities, will be closely monitoring progress and holding governments accountable for delivering on their commitments. There is still a huge gap in funding towards research – as civil society, we still call on our governments invest a certain percentage of annual expenditure on research and development in TB.

Despite being Africa’s second largest economy, South Africa has over the past five years seen serious economic pressures including political uncertainty and high unemployment levels. Inasmuch as the government has been addressing challenges related to inequality, poverty and access to public services; tuberculosis remains a huge problem!

South Africa is among countries with the highest burden of tuberculosis worldwide. According to World Health Organisation (WHO Global TB Report) – about 438 000 people fell ill with TB in 2016, 19 000 people developed Multi-drug resistant TB and 124 000 died due to TB.

WACI Health and other South African civil society under the leadership of TB-HIV Care have been putting pressure on government – advocating for a high political profile and development of more inclusive and sustainable health and social protection policies which ensure that no TB patient is left behind.

4 September saw the launch of South Africa’s Tuberculosis Caucus. The South Africa TB Caucus is a national constituent of the Global TB Caucus which consists of over 2 300 parliamentarians from 130 countries around the world. Members of the caucus adhere to the principles outlined in the founding document, the Barcelona Declaration.

Hosting this event was the Minister of Health, Dr. Aaron Motsoaledi. Parliament nominated patrons Ms. Baleka Mbete (Speaker of the National Assembly) and Ms. Thandi Modise (Chairperson of the National Council of Provinces) for the South Africa Tuberculosis Caucus (SA TB Caucus) and they will jointly take lead. Moreover, they signed the declaration on stage at the close of the evening.

Key highlights of the declaration included committing to finding missing cases, development of new and innovative tools for TB, prevention for TB including vaccines, and access & affordability of TB treatment.

Read more of the declaration  SA TB Caucus Declaration

After decades of overlooking Tuberculosis, it has finally emerged a worldwide political priority with the United Nations High Level Meeting scheduled for the 26^th of September. World leaders will convene at the United Nations General Assembly in New York at the first ever high-level meeting that will discuss and set strategies to end Tuberculosis by 2030.

In a letter written,  on behalf of civil society and community-based organizations committed to ending tuberculosis in Africa, to the African Union Chairperson – His Excellency Paul Kagame – Global Fund Advocates Network  (GFAN Africa Hub) welcomed the President’s commitment to attend the meeting and encouraged him to have African Heads of State and Governments involve civil society in their New York delegation.

Also included among the actions required to end TB in Africa and globally was a Common Africa Position paper on tuberculosis developed by civil society.

Read more Read More – TB HLM Letter

The World Health Organization (WHO) has published a global TB report every year since 1997. The main aim of the report is to provide a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease at global, regional and country levels. This is done in the context of recommended global TB strategies and targets endorsed by WHO’s Member States and broader development goals set by the United Nations (UN).

Read more here

The Washington Post
By Lena H. Sun
21 June 2018

Public health officials and business leaders like Bill Gates have long warned that the world is not ready for the next pandemic. Now an initiative led by Tom Frieden, former director of the Centers for Disease Control and Prevention, has developed a tool that spotlights gaps in preparedness, and actions that countries and organizations can take to close them. The new website, PreventEpidemics.org, gives an individual score to each country and uses color codes to rank the world by five levels of preparedness.

Read More Here

Tuberculosis (TB) remains an urgent public health threat and a leading infectious cause of death from a single infectious agent, ranking above HIV/AIDS. In 2014, the World Health Assembly resolved to end the global TB epidemic by 2035 which led to elaboration of the Sustainable Development Goals and End TB Strategy’s vision of making a world free of TB with no deaths or suffering due to the disease beyond 2015. As for 2016, about 10.4 million people fell ill with TB while 1.5 million deaths were recorded worldwide.

An ominous increase is being seen globally in the number of new cases of multi-drug resistant TB (MDR-TB). Over half a million new cases resistant to rifampicin (RRTB) – the most effective first-line drug – was reported in 2016, 47% of these cases were in India, China and the Russian Federation. Treatment of MDR tuberculosis is complex and expensive especially its most severe, extensively drug-resistant (XDR-TB) forms. Treatment is long (at least 2 years), drugs are toxic (specific expertise is needed to manage adverse reactions) and outcomes are poor (with low success and high death rates).

In a bid to attain specific targets set in the End TB Strategy through multisectoral action to address socioeconomic determinants and consequences of TB, WACI Health led 18 South African civil society organizations (CSOs) including TB affected communities co-signed a letter appealing to Head of State (HoS), Ministry of Health (MoH) and Ministry of Foreign Affairs (MoFA) commitment to attending the TB High-Level Meeting (TB HLM). TB remains the leading reported cause of death in South Africa with over 33 063 deaths (8.4% of natural deaths) in 2015. Other pertinent issues raised by CSOs comprised of establishing a national TB Caucus, investing in research, diagnostics and treatment for TB, developing a retainment strategy for health care workers, prevention strategy for all and TB response based on human rights approach.

To achieve the 90% reduction in mortality and 80% in incidence requires provision of TB care and prevention within the broader context of universal health coverage (UHC), financing and technological breakthroughs among others. Following political commitment from the Prime Minister towards ending TB by 2025, India’s domestic resource budget, for instance was substantially increased in 2017.

South Africa CSO team in partnership with Global Fund flew their flag high as they met with their SA Mission in New York to engage with them on key asks and requesting their assistance to urge HoS to lead the delegation to TB HLM, and also make sure that National Consultation with all stakeholders is held prior TB HLM to agree on country’s commitments, targets and effective response to TB.

Through the continuous engagement in-country Minister of Health, Dr. Aaron Motsoaledi, in his closing remarks at SA TB Conference on June 15, 2018 said:

“I received many requests and pleas from many TB advocates, including those attending this conference that South Africa must ensure that the country must participate in the HLM at the high level of leadership in government. As TB HLM is on 26 September 2018, we have not relaxed. We are mobilizing for all heads of state of BRICS countries to attend without failure because 50% of all drug sensitive TB as well as 60% multi-drug resistant TB in the world are found in BRICS countries. Presently South Africa is holding the chairpersonship of BRICS and so at the World Health Assembly in Geneva in May I was chairing a BRICS Ministers of Health meeting and I was given an assurance by BRICS Ministers of Health that they will do everything in their power to have their heads of state attending the High Level Meeting on TB. In addition, we asked our President to raise it next month during the BRICS Summit. We are currently chairing SADC and we will do the same to urge all SADC heads of state to attend. There is a forthcoming AU summit and we will also raise this issue at that forum.”

This for us is positive way towards big win and hope in having the South African government leading Africa to attend TB HLM and respond to TB more effectively while meeting the 2030 targets.