Invest in TB. Save Lives

Tuberculosis (TB) is the leading cause of death from a single infectious disease. About a quarter of the world’s population is infected with Mycobacterium tuberculosis. Consequently, a proportion of 5-10% of the 2 billion people will develop TB in their lifetime, with increased probability among people living with HIV and among people affected by risk factors such as undernutrition, diabetes, smoking, and alcohol consumption. However, TB is treatable and curable and it is projected that with adequate programming and funding for TB, it is possible to end the killer disease by 2030. Despite this, the current trends in achieving the milestones remain quite wanting.

In the wake of the COVID 19 pandemic, the TB response suffered devastating effects and recording a loss in progress for the first time in 20 years. It was reported by the Global Fund that there was an 18% drop in the number of people treated for TB in 2020. The same trend can be seen across other programmatic areas. The data was evaluated against 2019 results. The most immediate effect of the huge decline in the number of people diagnosed with TB was an increase in the number of people who died on TB in 2020.

Inadequate financing for TB remains the biggest barrier to achieving the targets to End TB by 2030, as highlighted in the Global End TB milestones which were developed during the 2018 United Nations High-Level Meeting on TB. At the meeting, world leaders pledged to deliver at least US$2 billion annually for TB research, of which US$550 million was assigned for vaccines. Despite these commitments, there is an annual shortfall for TB research funding of US$1.3 billion. This has been exacerbated by the pandemic as the limited financing that was available was stretched to its limits.

Never waste a good crisis” has been the post pandemic rallying call as we look to take lessons from the COVID 19 pandemic response and use them to ensure that END TB goals are met. Key among the lessons learnt is the need for adequate mobilization of funding to develop new TB vaccines as the current Vaccine in use was developed 100 years ago and has severe treatment limitations.

It is clear that the only way out is through. We can only end the pandemics if we invest in ending them and invest more than we ever have. To make progress in reducing the burden of tuberculosis disease, there needs to be adequate and sustainable funding for TB diagnosis, treatment, prevention, research, development and innovations globally and nationally. Adequate funding can be achieved through ensuring a fully funded the Global fund to End HIV TB and Malaria and through increased allocation of domestic resources for health for National TB response including funding for TB research development and innovation.

2022 presents a great opportunity to re commit to the national and global collective efforts of ending TB through pledging increased contributions to the Global Fund. A bold and necessary step towards ensuring reversal of the gains lost in the pandemic and to accelerate our progress towards ending TB by 2030.

The WHO World TB Day Theme, “Invest to End TB. Save Lives” is a timely reminder that to prevent the loss of lives to a preventable and curable disease we need to invest more to End

CategoriesGFAN Africa Run4TB

Cecilia Senoo: To defeat Covid-19, protect progress against HIV, TB and Malaria and save lives, we must unite to fight

Covid-19 struck and disrupted health, school, businesses, travel, play, prayer, and livelihoods. We have had to make decisions that affect our health in a way only seen and done in health facilities. While going out to the shop, we have to wear a mask and sanitize and the body temperature had better be right.

Covid-19 has reminded us of basic facts – that we must first secure our health to be able to deal with other facets of our lives. Public health is a pre-requisite to social, economic and political stability. That leads me to emphasize that investing in population-based services for preventing, detecting and responding to disease is needed for development.

Government must increase investments in health

When countries including Ghana were put in lockdown, access to healthcare services dwindled. People were afraid of going to health facilities when they fell ill for fear of having Covid-19 Stigma.

There was fear of catching Covid-19 at the health facility. This has resulted in the possibility of increased incidence of other diseases such as HIV, TB and malaria presenting fresh and unprecedented health challenges.

HIV, TB and malaria services were largely disrupted during the lockdown. A modelling report by the Stop TB Partnership indicates that as a result, global TB incidence and deaths in 2021 would increase to levels last seen in between 2013 and 2016 respectively – implying a setback of at least 5 to 8 years in the fight against TB, due to the Covid-19 pandemic.

A report by UNAIDS posits that the HIV response could be set back further, by 10 years or more, where Covid-19 has caused severe disruptions. Malaria prevention programmes were interrupted such as in the delayed distribution of mosquito nets.

Schools have been closed for months and gladly, they are gradually re-opening. For out-of-school girls, this can mean a greater risk of sexual exploitation, early pregnancy, forced marriage and HIV infection. The longer a girl is out of school, the less likely that she will return. The level of risk is enormous.

Countries must then focus on how best to accelerate the restoration of services, to bring the disease burden under control.

Measures to mitigate the impact of Covid-19 on HIV, TB and malaria should involve a combination of intensive community engagement and maintaining awareness of the importance of services to defeat the three diseases while emerging from the Covid-19 response. Programs must identify and address gender inequalities in their design and response.

One approach is to meaningfully engage women, supporting primary healthcare services needed to reduce child and maternal mortality; and supporting caregivers, who are mostly women, caring for those who fall ill from Covid-19 or other causes. Gender barriers to health must be removed.

Further, as we tackle Covid-19, health advocates, partners and governments must ensure that the response to Covid-19 includes strategies and lessons learned from the fight against HIV, TB and malaria and resources are allocated towards this.

Human rights must be protected; stigma and discrimination must be addressed. The available Covid-19 resources must ensure equitable access to screening, testing and treatment. When treatment and a vaccine is found, it should be available to everyone, one everywhere for free. So that no one is left behind.

This calls for a solid global collaboration to acceleratethe development, production and equitable access to new Covid-19 technologies.

Lastly, Covid-19 will not be the last pandemic. The next pandemic must find us better prepared, ready with strong and resilient health systems with a strong focus on primary healthcare founded on strong community health systems. A rights-based, equitable, people-centred system that is conscious of other factors that affect health and wellbeing such as climate change, food and housing.

To achieve these successes, the government of Ghana must invest additional domestic resources for health to build back better for a healthier and safer future. The government must consider health as an investment in human capital in the realization that health is a key factor in the development of our country.

We unite to fight and the beat continues for efficient, effective and affordable healthcare for everyone, everywhere.


Cecilia Senoo is the Executive Director, Hope for Future Generations
and Focal Person-GFAN-Africa

CategoriesGFAN Africa Run4TB

To Defeat COVID-19, Protect Progress against HIV, TB and Malaria, and Save Lives, We Must Unite to Fight

On 3 September, GFAN Africa, CS4ME and the Africa Coalition on Tuberculosis organized a webinar titled Dialogue on the HIV, TB and Malaria Response Amid COVID-19. The webinar is one of the series of activities organized by GFAN Africa as part of the #TheBeatContinues campaign in efforts to defeat COVID-19 and mitigate its effects of the disease on HIV, TB and Malaria. In her remarks, Linda Mafu the head of Civil Society and Political Advocacy at the Global Fund noted that COVID-19 is a global emergency that requires a global response. She emphasized that in the spirit of UHC, no one should be left behind. She called for deep community engagement as communities are most affected by COVID-19; which has resulted in increased out of pocket spending leading to more poverty and increased vulnerability to HIV, TB and malaria

Maurine Murenga a community leader and a global health advocate noted that during crises, girls and women suffer the most. “When girls are out of school for long, as has been occasioned by COVID-19, they are less likely to go back. While in school, they are less likely to engage in sex and are less vulnerable to HIV”. She underscored the need for a gender sensitive approach to the COVID-19 response. In addition, she noted that economies have been weakened by COVID-19. She called for civil society creativity in advocacy for the allocation of increased domestic resources for health. “This year is tough in the fight against malaria. There have been difficulties and delays in distributing mosquito nets because of the COVID-19 disruption” noted Olivia Ngou the Executive Director of Impact Sante Afrique. She added that the situation is further complicated because communities are avoiding visiting health facilities when they have a fever. She emphasized the need for increased advocacy at community level to encourage communities to seek healthcare services when they have a fever or fall ill. She added that the protection of frontline healthcare workers is of utmost importance.

Here are the key messages from the webinar

[slide-anything id=’9403′]

To defeat COVID-19 and safeguard the critical fight against HIV, TB & malaria, additional domestic and international funding is needed. We must measure success not just in reducing the death toll from COVID-19; but also in reducing the impact of the pandemic, including the knock-on effects on existing diseases. Without additional funding to fight COVID-19, countries will; be unable to deliver on their targets for lifesaving services for ongoing HIV, TB and malaria programs; be unable to purchase personal protective equipment (PPE) to protect their health workers, putting their lives at risk and contributing to ongoing transmission of the virus; and be unable to purchase additional COVID-19 tests or treatments that are critical to fighting the virus and saving lives.

To defeat COVID-19, the response must address gender barriers, stigma & discrimination, and protect human rights. The global response to COVID-19 must take lessons from the fight against HIV, TB and malaria. These include ensuring that the response protects human rights and address stigma and discrimination and removes gender and human rights barriers to health.

To defeat COVID-19, protect progress against HIV, TB and malaria, and save lives, we must unite to fight. Diseases do not respect borders. The COVID-19 pandemic makes it clear that our global health security is only as strong as the world’s weakest health system.  Around the world, people are uniting to fight. Health workers, governments, businesses, technical agencies, advocates and individuals are working together to continue the fight against infectious diseases and save lives. The Global Fund, the largest multilateral investor in grants for health systems worldwide, has provided immediate funding of up to US$1 billion to help countries fight COVID-19, mitigate the impact on lifesaving HIV, TB and malaria programs, and prevent fragile health systems from being overwhelmed. As advocates across the Africa region we are uniting to fight.

We #UniteToFight HIV, TB, Malaria and COVID-19 to save lives and so #TheBeatContinues

CategoriesGFAN Africa Run4TB Uncategorized

It’s TIME to Find and Treat All People Suffering from TB

On 24th March, we marked the World TB Day. The theme for this year was, IT’S TIME. It’s indeed time to end TB. One missing person can infect up to 15 people with Tuberculosis (TB) every day.

Globally, over 4 million persons with TB were missed in 2016. Patients are considered “missing” when they have not been diagnosed, haven’t been notified of their status or if they default on treatment.

World TB Day campaign in March Photo credit: Ghana TB Voice Network/2019

Despite vast efforts to educate the public on the risk factors associated with TB, large numbers of people diagnosed with the disease still do not get treatment for reasons such as stigma attached to the disease, or because they think that they have been cured after taking medication for less than the prescribed six-month period. Diagnostic delays is also a factor contributing to missing persons. Health system failures, such as poor recording of patients’ contact details, poor follow-up of patients who do not return to collect their test results, results not being available when patients return to the health facility and perceptions of poor quality of services (long waiting times, disrespectful staff) need to be addressed.

Its TIME to END TB Photo Credit: Joy/2019

With the global TB incidence declining at only 1.5% per year, we are not on track for an 80% reduction in TB incidence by 2030. There is an urgent need for Governments to commit more resources for health to defeat the disease. We ask Governments to commit at least 5% of their GDP to health so that broadly, they build resilient and responsive health systems that provides comprehensive primary health care based on the principle of leaving no one behind.

In October this year, France will host the 6th Global Fund replenishment conference to raise at least US$14 billion to end HIV, TB and malaria. Investments in the Global Fund have saved more than 27 million lives since 2002. A fully funded replenishment will enable the Global Fund to scale up its effective responses and get the world back on track to fight the three diseases and save lives. Resources from the Global Fund and domestic resources from Governments when put together, will support the building of strong health systems.


CategoriesBlog Run4TB

Georgia trials could revolutionize treatment of drug-resistant TB

By Sophie Edwards, 26 September 2018 –

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.

At the same time, advocates are preparing for the first United Nations high-level meeting on TB in New York on Wednesday, which they hope will help drive political and financial commitments toward the disease.

According to the World Health Organization’s latest TB report, published last week, it killed 1.6 million people in 2017, down from 1.7 million in 2016, making it the most deadly infectious disease worldwide. Advocates say progress is not happening fast enough to reach the End TB milestones by 2020.

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.

CategoriesBlog Run4TB

Wanted leaders for a TB-free world – A South African experience

Recently, WACI Health led diverse South African stakeholders in the TB community, including representatives of civil society, the private sector, TB-affected communities, and other constituencies, developed a set of key asks proposing specific commitments and targets for the draft political declaration of the High-Level Meeting.

This comes at a time when the world is calling on building commitment to end TB, not only at the political level with Heads of State and Ministers of Health, but at all levels from Mayors, Governors, parliamentarians and community leaders, to people affected with TB, civil society advocates, health workers, doctors or nurses, NGOs and other partners. All can be leaders of efforts to end TB in their own work or terrain

Attached are the letters addressed to the President of South Africa and also the respective minsters to attend this high-level meeting.

For full letter read :

Ramaphosa Announcement to attend TB

HLM -Press_Statement_HLM

President Ramaphosa – TB HLM Minister Sisulu-TB HLM

CategoriesNews Run4TB

Red Alert On TB Infection Control In Clinics

– Results of TAC survey of 207 public clinics shows TB infection control still falling short.        – Government must urgently conduct an infection control audit of all public facilities

JOHANNESBURG, 19th MARCH 2018 – In the run up to World Tuberculosis (TB) Day on 24 March 2018, the Treatment Action Campaign (TAC) assessed the state of TB infection control in a number of clinics across South Africa. Of 207 facilities assessed, 145 were found to be in a “RED” state with very poor infection control measures in place.

In March 2017, TAC produced our first annual TB audit. Last year, 72% of the facilities (115 out of 158) were ranked “RED” compared to 71% (145 out of 207) this year. 9% of facilities (15 out of 158) scored “GREEN” last year, compared to a dismal 1% this year (2 out of 207).

TB remains the leading reported cause of death in South Africa with over 33 063 deaths (8.4% of natural deaths) in the country in 2015[1]. Based on the latest data in 2016, the rate of new cases of active TB in South Africa remains extremely high at around 438 000[2]. While total TB rates do appear to be slowly declining (down from 250 000 in 2015), multi-drug resistant TB (MDR-TB) and extreme drug resistant TB (XDR-TB) rates are increasing. The World Health Organization (WHO) estimated 19 000 cases in South Africa in 2016 up from 7 350 in 2007[3]. TB can be spread through the air when people with active TB disease cough or sneeze. However, various infection control measures can be taken to reduce the risk of TB transmission.

“Our clinics should be places we feel safe, where we know we can get decent healthcare services. They certainly should not be places we can get TB. The reality is that many clinics aren’t even doing the basics to prevent us getting TB as we wait to see a nurse. They are overcrowded. People are not screened for TB. Often staff don’t even offer a tissue to someone coughing,” says Sibongile Tshabalala, TAC National Chairperson.

TAC branches in Eastern Cape, Free State, Gauteng, KwaZulu-Natal, Limpopo, Mpumalanga, and Western Cape engaged in the audit during TB month, March 2018. The following questions were answered by TAC members from local branches linked to each facility assessed:

  1. Is there enough room in the waiting area?
  2. Are you seen within 30 minutes of arriving at the facility?
  3. Are the windows open?
  4. Are there posters telling you to cover your mouth when coughing or sneezing?
  5. Are people in the facility waiting area asked if they have TB symptoms?
  6. Are people who are coughing separated from those who are not?
  7. Are people who cough a lot or who may have TB given tissues or TB masks?

Based on the answers facilities were ranked RED (3+ questions answered “no”), ORANGE (1-2 questions answered “no”), or GREEN (0 questions answered “no”).

145 facilities were ranked “RED”, 56 facilities were ranked “ORANGE”, and only 2 facilities were ranked “GREEN”. 4 facilities were unable to be ranked due to incomplete data.

  • Facilities performed especially poorly in the length of waiting times, where over 90% of facilities (190 out of 207) failed to see people within 30 minutes of arriving, pointing to widespread human resource shortages across the clinics surveyed.
  • 57% of facilities (119 out of 207) did not screen people for TB symptoms who were waiting to be seen and 56% of facilities (115 out of 207) did not offer tissues or TB masks to those coughing. It is unknown if this is due to a lack of resources, time, or will.
  • 38% of facilities were found to be too small, and just under 70% of facilities did not (or could not) separate people who were coughing a lot from those who were not, pointing in part to infrastructural challenges that need to be addressed.

TAC commends the 2 clinics that were ranked GREEN – Goso Forest Clinic (EC) and Rhodes Clinic (EC). Our local branches linked to the 2 clinics will award them with certificates and urge them to continue ensuring effective TB infection control. However, if we wish to make progress against TB GREEN ratings should be the norm in the public healthcare system, not the exception.

An Excel sheet with the survey results (including provincial breakdown) can be accessed here.

The problems highlighted in TB infection control through the audit are indicative of the wider crisis within the health system, where overstretched nurses at understaffed clinics lack the capacity and resources to engage effectively in infection control measures.

“While we stress that this is by no means a scientific survey and the results are not generalisable to the rest of the public healthcare system, it does suggest that infection control is a significant problem in many public sector health facilities. As a result, we demand that government carries out a full audit of all public buildings in South Africa, including schools, clinics, hospitals, correctional facilities and home affairs facilities, to assess whether sufficient TB infection control measures are in place,” says Tshabalala.

If the government is serious about tackling TB, then infection control must be made a priority this yearWe do not want to be raising the same issues this time next year – our 2019 audit must see a total turnaround of this situation.”

TAC branch, provincial and national leaders will be meeting with facility management, provincial and national health departments in the coming weeks to discuss the poor outcomes of our TB infection control survey.

All commitments and responses from these meetings will be published.


For more information and to arrange interviews contact:

Lotti Rutter | | 072 225 9675



The full 2018 survey results can be found here:


For a breakdown of TB infection control results per province please see the following overviews:

Eastern Cape overview:

Free State overview:

Gauteng overview:

KwaZulu-Natal overview:

Limpopo overview:

Mpumalanga overview:

Western Cape overview:


The 2017 infection control audit can be found here:

NOTE: Not all facilities surveyed in 2017 were repeated in the 2018 audit, and several additional facilities were included this year.

NOTE: Even though TB is the number one reported cause of death in South Africa according to official death notifications, many deaths attributed to TB and other causes are in people with HIV and HIV is thus underrepresented in death notifications. The Thembisa model of HIV in South Africa estimates that there are roughly 150 000 HIV-related deaths per year. A recent Medical Research Council report estimates around 150 000 HIV-related deaths in 2012. These estimates indicate that HIV is still the number one cause of death in South Africa.


A summary of results is available here:

Province Is there enough room in the waiting area for everyone? Are you seen within 30 minutes Are the windows in the facility open? Are there posters telling you to cover your mouth when coughing or sneezing? Are people in the facility waiting area asked if they have TB symptoms? Are people who are coughing separated from those who are not? Are people who are coughing a lot or may have TB given TB masks or tissues?  RANK
Eastern Cape 17 20 1 5 15 15 18 Green – 2
Orange – 6
Red – 20
Free State 16 33 1 5 23 32 28 Green – 0
Orange – 3
Red – 31
Gauteng 10 24 4 6 11 17 17 Green – 0
Orange – 5
Red – 17
Unknown – 2
KwaZulu-Natal 11 23 1 1 8 14 9 Green – 0
Orange – 15
Red – 11
Unknown – 2
Limpopo 3 29 1 8 17 21 15 Green – 0
Orange – 11
Red – 20
Mpumalanga 15 35 1 9 26 20 27 Green – 0
Orange – 8
Red – 27
Western Cape 7 26 0 5 19 25 1 Green – 0
Orange – 8
Red – 19
National 79 190 9 39 119 144 115 Green – 2
Orange – 56
Red – 145
Unknown – 4



[1] National Strategic Plan on HIV, TB and STIs 2017 – 2022. SANAC. Available at:

CategoriesBlog Run4TB

WHO TB Report

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.

The data in this report is updated annually.

[pdf-embedder url=””]

CategoriesRun4TB WACI Health News

The African Civil Society Platform on Health and GFAN Africa Urge African and World Leaders to Urgently Address Drug Resistant TB


Carol Nawina:  + 260 97 7960043
Rosemary Mburu:  +254 711 308858
Emmanuel Etim: + 251 912 623 935


Drug Resistant TB: Time to Act is now

Tuberculosis is killing more people than any other infectious disease; close to two million people died from TB last year. The rise of these reported TB cases is a big cause for concern.

“But the emergence of new superbugs that can resist even the most powerful antibiotics should make bigger headlines”, Says Rosemary Mburu, Executive Director, WACI Health. “While antimicrobial resistance is going to affect treatment for many health conditions, drug-resistant TB is particularly concerning as it accounts for about one-third of all antimicrobial resistance deaths”.

The growth of these forms of drug-resistant TB has a potentially disastrous impact in the fight against the disease. In 2015, there were approximately 580,000 cases of drug-resistant TB. Only 20 percent of those were diagnosed, treated or reported to national health systems across the world. Drug-resistant TB ended up killing 250,000 of people that year.

“This form of the disease now threatens many recent gains made against the response to TB and HIV globally,” said Carol Nawina- Kachenga, Executive Director, CITAM+. “Over the last few decades, the global community has worked so hard to defeat HIV. Today, Tuberculosis, the world’s most infectious disease is threatening to reverse these gains by killing our communities. It is killing our grandmothers in Kinshasa, our mothers in Soweto, our brothers in Ndola and children[1] all over Africa. It is pushing us further into poverty and killing our dreams.

“Africa is home to four of the 27 global high multidrug-resistant TB burden countries: Democratic Republic of Congo, Ethiopia, Nigeria and South Africa.” Says Olayide Akanni, Executive Director, Journalists Against AIDS, Nigeria. “ Our people continue to suffer in the face of lack of new drugs to treat drug-resistant TB and ineffectiveness of existing treatments, which are long and often cause adverse side effects.”

A widespread epidemic of extensively drug-resistant (XDR) tuberculosis is also unfolding in South Africa, where cases have increased substantially since 2002. Alone, the country contributed 562 of the 4,040 XDR-TB cases enrolled on treatment globally in 2014. “This is a time bomb in South Africa and President Jacob Zuma must champion TB R&D in South Africa and globally, through his G20 membership,” says Daniel Molokele, Steering Committee Member, CISPHA.

Global health partners must halt and reverse the growth of drug-resistant TB. The time to act is now.

On World TB day 2017, we, members of the CISPHA and GFAN Africa, united in our resolve to ending TB:

  1. Join other global health organizations in calling for TB to be added to the World Health Organization’s list of high priority drug-resistant bacteria. Our call comes in the wake of WHO’s first ever list of antibiotic-resistant pathogens released as part of the effort to address the growing threat of antimicrobial resistance. Currently, that list does not include TB.
  1. Call upon African governments to prioritize tuberculosis in national health and development agendas by increasing investments in research and development for TB to support creation and uptake of new tools and drugs to respond to drug-resistant TB.
  1. In the run-up to the upcoming G20 meeting in Hamburg, Germany, in July, we call upon G20 leaders – including President Jacob Zuma – to demonstrate leadership in responding to drug-resistant TB by committing to fund new research to develop better drugs and treatment regimens to respond to the disease.



About CISPHA: The Civil Society Platform on Health in Africa (CISPHA), is an Africa regional advocacy platform, which aims at a coordinated Civil Society response on health in Africa.  The Platform was launched in 2009, when 60 networks and network organizations, joined forces to utilize evidence for Advocacy and Lobby at continental level, linking the efforts at national and regional levels to influence decision processes at the African Union and its institutions. CISPHA is hosted by WACI Health.

About GFAN Africa: Nested within CISPHA, the Global Fund Advocates Network (GFAN) Africa is a regional hub for GFAN. GFAN Africa unites voices and efforts from all over Africa to support a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria.

[1] In high burden TB settings it has been noted that 15-20% of all TB cases are among children.

CategoriesBlog Run4TB

We Must Invest in TB-HIV Programming or Lose Two Fights at Once

By Stephen Mule

This year, the two deadliest infectious diseases traded places. The World Health Organization (WHO) announced that tuberculosis had overtaken HIV, as the deadliest infectious disease globally. The WHO report, released in October, estimated that there were almost 10 million new cases of TB in 2015. The disease killed 1.5 million people, ahead of 1.2 million claimed by HIV. For those of us who have committed ourselves to ending TB by 2030, this is extremely disconcerting.

But it doesn’t have to be that way. Advances in science have brought us so far that we cannot allow this disease to beat us now. One of the most important of those scientific imperatives is the understanding of how these two diseases fuel each other. For instance, TB kills more than a 1000 people living with HIV every day. To end HIV as an epidemic, we must end TB as an epidemic and vice versa.

To end this deadly combination, we must respond aggressively to co-infection between the two diseases. In 2004, WHO established guidelines on addressing HIV-associated TB, emphasizing the necessity of linking TB and HIV services. The guidelines also outlined a set of joint activities that needed to be delivered to address the interface between the two diseases. Those guidelines evolved further into a more complex mechanism that sought to expand detection and prevention of TB, among people living with HIV. The approach also aimed at enhancing ownership of TB-HIV work, especially among people working in the HIV field. The WHO updated those policy recommendations in 2012, giving greater clarity on 12 specific activities needed to improve health services and health outcomes for people with, and at risk of, TB and HIV.

To end these two epidemics, we need to make sure that these policy guidelines are implemented. Doing that is one of the key ingredients in sending these two diseases into retreat. In 2014, ACTION Global Health Advocacy Partnership investigated whether the guidelines had been translated into commitments at global and national levels and produced a report titled From Rhetoric to Reality.  The study showed that while bold policy steps had been taken to fight both TB and HIV, much more was needed. To address gaps, ACTION recommended that national HIV strategic plans prioritize TB-HIV joint activities—with a specific focus on screening all people living with HIV for TB—to ensure access to TB prevention, testing, treatment, and care.

Two years later, ACTION conducted another study and released a report titled From Policy to Practice. This report explores the progress made in TB-HIV integration efforts since 2012. It shows that HIV programs globally are lagging behind in accelerating TB-HIV activities, while TB programs are, comparatively, performing well in their efforts to accelerate TB-HIV activities. The study also found that global guidelines to address TB-HIV have not been prioritized by leading donors and affected countries.

To defeat TB and HIV, we have do more. The HIV community cannot afford to be left behind any longer in instituting joint TB-HIV integration.

International funders of HIV must also invest more vigorously in TB-HIV programming. The science is unequivocal in showing that more work around where these two diseases interact is indispensable to ending these highly interlinked diseases.

In the last twenty years, we have had remarkable investments in responding to HIV and tuberculosis. Without a doubt, great progress has been made against these diseases. But to end them as epidemics by 2030, we must accelerate our investments and implementation in TB-HIV activities.

The window is closing fast. The choices are stark. We must find ways of doing greater TB-HIV integration or risk losing two fights at once.

Stephen Mule is a Member of Parliament in Kenya and the Chair of Africa TB Caucus.

Copyright © 2023 WACI HEALTH. All Rights Reserved. Designed By Pinch Africa.