In an unprecedented demonstration of support for a single global health issue, over 170 parliamentary representatives from across the G7 and the European Parliament have released a statement calling for a renewed global commitment to “drive down rates of TB across the world and to accelerate progress towards ending TB as a threat to global public health.”
Every year, TB kills 1.3 million people. Long considered eradicated in the West, it remains a threat to public health all around the world. Although the burden is heaviest in sub-Saharan Africa and South Asia, nearly every country in the world has cases of TB. Far from reducing rates of the disease, some leading economies like the UK have in fact seen increases in rates since the turn of the century.
Of particular concern is the development of drug-resistant TB, some strains of which are practically impossible to treat. The European Centre for Disease Control revealed last week that only 1/3rd of multi-drug resistant TB (MDR-TB) patients finish TB treatment successfully. Globally, fewer than 10% of all MDR-TB patients are cured of the disease. “If we do not act to eliminate TB, if the spread of DR-TB is allowed to continue unabated, patients, families and health systems all around the world will struggle to deal with the costs.” The statement reads.
Drug-resistance is a man-made problem stemming from poor management of the disease. Patients who fail to complete the course of up to 5,000 pills of toxic drugs required to treat the disease risk developing drug-resistant strains. With limited new drug development in 40 years, alternative treatment options are limited and carry the threat of permanent and debilitating side-effects.
TB, drug-resistant or otherwise, is an airborne infectious disease and does not respect national boundaries. “No country can solve the tuberculosis epidemic by working alone.” Explained Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership. “This unprecedented call to action on behalf of G7 countries and the European Parliament shows that countries are committed to the collective goal of zero new tuberculosis deaths. I hope this will be the beginning of a strong collective effort by parliamentarians to ensure TB is a global development priority and receives the needed investments to ensure a successful global response now and beyond 2015.”
The global response to TB has, so far, struggled with chronically low levels of funding. The pinch is felt particularly in regards to R&D, where an annual estimated funding gap of over $1.3bn is hampering efforts to develop much needed new drugs, diagnostics and vaccines for TB.
Of course, as new drugs are developed, enormous challenges remain in ensuring that all TB patients have access to them. “This year, 3 million people – a third of all new TB cases – will be “missed” by health systems.” Says the statement. “Some will not be diagnosed, some will not be treated, some will access health services but with no guarantee of receiving the right care.”
The ‘3 million missing’ has barely changed for 7 years and is the theme of this year’s World TB Day. “Diagnosing and treating everyone with TB is the bare minimum of what we should expect,” says Nick Herbert MP, co-chairman of the UK All Party Parliamentary Group and the architect of the statement, “TB is an infectious disease. A single, untreated person can spread the disease to 15 other people each year. The unfortunate truth is that our current systems simply aren’t good enough, we need new ideas and new ways of working if we’re going to reach everyone who has the disease.”
Mr Herbert points to the Stop TB Partnership’s TB REACH programme as a model for innovation. “TB REACH exists for one reason: to find innovative ways of diagnosing and treating more people with TB. If we don’t fund innovation, we’ll be stuck with existing interventions, and existing interventions are clearly insufficient. This is a critical moment in the fight against TB, if we scale-up, if we invest in innovative new approaches we can eliminate TB in our lifetimes, but no country or organisation can do it alone. We need a global commitment to tackle a global disease.”
Leading civil society figures agree. Aaron Oxley, Executive Director of RESULTS UK, says: “The latest numbers paint a picture of an increasingly deadly, increasingly costly, and increasingly global disease that crosses borders and seeks out the vulnerable and marginalised wherever they live. This statement shows that the G7 is beginning to show the leadership we need, but political leadership must be followed by global action if we are going to beat tuberculosis.”
Mr Herbert is quick to point out that, although the UK All Party Parliamentary Group led the project, the goodwill shown by parliamentarians around the world has been remarkable. “We’ve really been taken aback by the support that this statement has received, across geographical and political divides. If we can continue this collaborative approach to tackling the disease, I’m confident that we can, as the statement says, be the generation that ends TB.”