25 January 2019 – Nairobi, KENYA. In preparation for the Africa Leaders Meeting on Investing in Health, taking place in Addis Ababa, Ethiopia, on 9th February; and in the lead up to the 6th replenishment of the Global Fund in October, health advocates in Africa, under the Civil Society Platform for Health and the Global Fund Advocates Network (GFAN) Africa, have met and emphasized the need for African governments to step up domestic resources for health.
There are about 1.8 billion young people aged between 10 to 24 years in the world. This is by far the largest generation of youth in history! Approximately half of them – 900 million – are adolescent girls and young women.
Majority of the adolescent girls and young women live in low and middle-income countries. With regards to HIV, this young cohort is disproportionately affected by the virus. In 2016, 2.3 million adolescents and young women were living with HIV. Eastern and southern Africa regions carry the heaviest burden with an estimated 230 000 new HIV infections annually. Overall, the number of African adolescents and young people is estimated to increase to more than 750 million by 2060. Bearing these projections in mind, new HIV infections among young people are expected to rise even if our global progress to HIV response is maintained.
To end AIDS as a public health threat by 2030, UNAIDS estimates US$26.2 billion is needed for the global HIV response in 2020 alone. This means the world must increase the amount of resources available for HIV by US$1.5 billion each year between 2016 and 2020. There is a lot more emphasis on countries most affected by the HIV epidemic to finance their own responses and find more efficient and cost-effective ways to do so.
The world will convene in France in October 2019 for the 6th replenishment of the Global Fund to raise new funds towards ending AIDS, TB and Malaria by 2030 in alignment with the Sustainable Development Goals. In addition to the pledges which will be made, there is an increasing need for implementing countries (of the Global Fund grants) to step up their domestic resources for health especially investments in young women. There is limited research within the HIV evidence base specifically among adolescents and young women. Where data on youth exist, the way it is presented sometimes fails to tell the full story.
Photo credit: PEPFAR
Girls and women are powerful agents of change as well as drivers of sustainable development. Evidence from around the world confirms that investing in girls and women, by education and health, creates a ripple effect that yields multiple benefits such as greater accumulation of human capital; increased productivity, income and economic development. For example, a study in Botswana found that each additional year of secondary schooling by adolescent girls reduced cumulative HIV infection risk by 8.1%. Yet, despite all we know, decision makers have failed to consistently make adolescent girls and young women a priority. They are deprived of access to health services, confront barriers to education, are vulnerable to gender-based violence and face discrimination in political and economic spheres.
Now, at the dawn of the SDGs, we have an opportunity to correct this wrong and prioritize the health, rights, and wellbeing of girls and women everywhere.
NAIROBI, Jan. 25 (Xinhua) — African lawmakers and civil society organizations on Friday urged governments to increase domestic healthcare expenditure in order to end life-threatening epidemics such as HIV, malaria and Tuberculosis (TB).
Stephen Mule, Kenyan legislator and chair of the Africa Parliamentary TB Caucus, told a health forum in Nairobi that African countries have not yet prioritized the health sector in their budgets.
“On average African governments health budgets are less than 1 percent of their gross domestic products (GDP) against an ideal figure of five percent,” Mule said during the Conference on Raising Resources for Kenya’s Health Pillar Under Agenda Four.
The day-long event brought together African civil society organizations and parliamentarians to share their views on how Kenya can raise resources to deliver universal healthcare to all its citizens by 2022.
Mule also noted that most African states are yet to fulfill the 2001 Abuja Declaration where African Union member countries pledged to allocate at least 15 percent of their budgets to the health sector.
He added that most of the funding for health in Africa comes from foreign donors, a situation that is not sustainable in the long run.
The parliamentarian said that rich countries are also facing pressures from their citizens to reduce overseas development assistance to poor countries.
Rosemary Mburu, executive director of WACI Health, said that Africa should embrace innovative measures to enhance domestic resource mobilization to fund the health sector.
Mburu said that Africa should prioritize the health sector due to its significant influence on national development.
Olivia Ngou, global coordinator for Civil Society for Malaria Elimination, said that in October 2019, the international community will come together in Lyon, France, to raise funds for the sixth replenishment of Global Fund to Fight Aids, Tuberculosis and Malaria.
Ngou said that African countries are key beneficiaries of the global fund and should strongly support this international effort to raise more funds for the global fund.
By Sophie Edwards, 26 September 2018 – www.devex.com
TBILISI, Georgia — As world leaders gear up for a landmark United Nations meeting on tuberculosis this week, two pivotal trials in the small Eurasian country of Georgia are promising to break new ground in the fight against multidrug-resistant TB.
July saw the launch of the SimpliciTB trial at the National Center for Tuberculosis and Lung Disease in the capital, Tbilisi, which combines four new medications and aims to slash treatment times by a third or more.
A pill in a hand. Photo by: rawpixel
It comes on the back of the ZeNix trial, launched last November, which targets patients with the most resistant form of the disease and is already showing signs of success in cutting treatment times. Both trials are being run by the TB Alliance in a country that has one of the highest prevalence rates for drug-resistant TB in Europe.
Drug-resistant TB has become a growing problem, with an estimated 558,000 new patients in 2017. The majority of these patients are classed as having multidrug-resistant TB — or MDR-TB — meaning they are resistant to more than one first-line drug. Treatment in these cases can be lengthy, complex, and expensive, with severe side-effects. As a result, only 55 percent of MDR-TB patients are cured, according to WHO.
Countries of the former Soviet Union, including Georgia, have the highest rates of drug-resistant TB, but infection rates have been increasing rapidly in parts of Africa and Southeast Asia.
While there have been innovations in treatment, these have taken time to approve and are still not widely available, especially for poorer patients.
The Tbilisi drug trials offer hope for patients with drug-resistant TB by giving them access to combined oral-only regimens — in place of older, injection-based treatments — which are less toxic and require a shorter treatment time.
Patients on the ZeNix trial, set to run for four years, are already showing promising results almost a year in, according to lead clinician Lali Mikiashvili. Eight patients have now finished the six-month treatment and have been “cured,” she said, although they will be kept under close observation for signs of relapse for a further 18 months. The remaining nine patients are still on treatment but are responding well, she said.
“It is a revolutionary regimen; it’s unbelievably simple and short,” Mikiashvili said, adding that while the trial is ongoing and will be formally evaluated at a later date, so far “every patient has responded quickly, showed high efficacy and tolerability … [and] none have shown serious side effects.”
“If successful, this is the future treatment for hundreds of thousands of patients suffering from one of the most dangerous diseases in the world,” she said.
While ZeNix focuses on patients with highly-resistant TB, SimpliciTB is for those with both ordinary TB and MDR-TB. The trial is testing a regime of four drugs, all of which can be taken orally, known as BPaMZ, to see whether it can cut and simplify the treatment process down to four months for those with drug-sensitive TB, and six months for those with more resistant strains. Current treatment times for MDR-TB can be up to two years.
Marika Eristavi, who is leading the SimpliciTB trial, said patients are responding well to the new treatment. If successful, it could “reduce the rate of TB in Georgia as well as worldwide,” she said.
Other SimpliciTB trials are also being set up, with the aim of treating 450 people across 10 countries in Africa, Asia, Europe, and Latin America.
TB Alliance, a nonprofit that works to accelerate the development and affordability of new TB drugs, is managing both trials.
“As resistance to current TB treatments continues to grow, we need to introduce all-oral drug regimens that can treat every person with TB in six months or less, regardless of their resistance profile,” said Mel Spigelman, president and CEO at TB Alliance. “If proven successful in SimpliciTB, the BPaMZ regimen would represent a major step toward this goal.”
Eristavi told Devex she hopes the forthcoming high-level meeting on TB can help secure more funds for research and development.
“R&D will help … discover new medicines, treatment regimens, and vaccines, which is essential to tackle this disease,” she said.
But while both trials offer hope, Mikiashvili pointed out that TB is one of the oldest diseases in the world and has a history of defeating so-called cures, including streptomycin, to which the disease showed resistance within months of it being introduced in the 1940s.
“The TB bacteria is very flexible … It has the ability to acquire resistance to all medications,” she said. “When streptomycin was introduced it was said it was the end of TB … worldwide, but who now remembers streptomycin?”
NCDs. Climate change. Financing. Read more of Devex’s coverage from the 73rd U.N. General Assembly here.
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:
We need new tools for TB as well as universal health coverage because those who are most affected by TB are those who have most difficulty accessing health care,’ South Africa President, Cyril Ramaphosa
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 asksand 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.
After decades of overlooking Tuberculosis, it has finally emerged a worldwide political priority with the United Nations High Level Meeting scheduled for the 26th 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.
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).
Strengthened advocacy on domestic resource mobilization.
Through the Civil Society Platform on Health in Africa (CiSPHA) and Global Fund Advocates Network (GFAN) Africa, we worked with civil society to advocate for increased domestic investments in health. We provided civil society partners with data and other advocacy tools, at the national and regional levels and also facilitated development of messages, including a blog on Domestic Resource Mobilisation. We worked with regional and national civil society platforms to support civil society and community engagement with decision makers at various levels. For example, through GFAN Africa, WACI Health provided technical and financial support to partners in Kenya, Tanzania and Senegal on domestic resource mobilization. These efforts contributed to strengthening of the Civil Society Health Platform in Senegal, which would later become an avenue for civil society and community engagement in the development of the National Health Financing Strategy. In Tanzania, this work contributed to the development of a Civil Society Platform on Domestic Resource Mobilization, which is set to facilitate and strengthen Civil society and community engagement in Domestic Resource Mobilization.
(DRM) advocacy. At the sidelines of the Africa Partnership and Coordination Forum in November 2017, WACI Health led a group of civil society Organizations in organizing a CSOs regional meeting on DRM. At the meeting, CSOs pulled together a position paper on DRM, which was then shared with a wide range of stakeholders at the main forum. The forum serves as a continental platform to chart a collective way forward, identify opportunities for joint action, advocate for continued political commitment, and coordinate the efforts of the different partners to improve the health outcomes in Africa. Participants are drawn from the African Union Commission and its organs, regional economic communities, multilateral and bilateral development partners, non-state actors, parliamentary sector, UN agencies, and regional networks of community groups.
Tuberculosis — the world leading infectious disease – killed about 1.7 million people in 2016. Additionally, more than 10 million people globally got sick with the disease and about four million of them failed to be diagnosed, treated or reported by health systems.
The global state of TB management remains dire and the aim to end the epidemic by 2030 as agreed in the Sustainable Development Goals is still way out of reach. To change this, global health partners must pull together. To contribute to that effort, WACI Health is determined to keep TB prevention, treatment and management in the frontline. WACI Health and other global health partners demand and support efforts to accelerate action against TB.
In Africa, we are working with civil society organisations to galvanise and support leaders to champion more investments and better TB policies. For instance, we were part of a group that pushed to have more members of parliament attend the Global Ministerial Conference on Ending TB in the Sustainable Development in Moscow in November 2017. We are also supporting similar initiatives for the 2018 UN High-Level Meeting on TB in New York, to encourage the attendance of as many African heads of state as possible and to ensure that civil society key asks are prioritised by the heads of state. In commemoration of World TB Day in 2017, we issued a news release through the Africa civil society platform on health and GFAN Africa, with a focus on drug resistant TB. We called on WHO to add TB to its list of high priority drug-resistant bacteria and called on African governments to prioritise tuberculosis in national health and development agendas. We further challenged G20 leaders to demonstrate leadership in responding to drug-resistant TB by committing to fund new research to develop better drugs and treatment regimens. In South Africa, our World TB Day activities involved working with Section 27 and Treatment Access Campaign (TAC) to host two workshops — for TAC members in Free State Province and for Buffalo City Municipality AIDS Council civil society sector members in Eastern Cape. In both meetings, we underlined the need for civil society movements to play a greater role in advocating for proper implementation of the South Africa’s national TB strategic plan. In Kenya, we participated in the launch of Kenya’s first TB prevalence survey 2015/2016. We also participated in schools’ campaign to promote TB awareness in schools and the community. School children were engaged in essay writing and a photo competition on TB control in their communities. WACI Health worked with Hon Stephen Mule, Kenyan Member of Parliament and Chair African TB Caucus, to write a blog on the integration of TB and HIV.
