High-level Hopes to End TB

Outside the UN General Assembly Hall where the High-level meeting on tuberculosis was held on September 26, 2018 .
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Outside the UN General Assembly Hall where the High-level meeting on tuberculosis was held on September 26, 2018. Image: Dayna Kerecman Myers

NEW YORK—The UN General Assembly’s first ever High-level Meeting on Tuberculosis this past Wednesday culminated in a slew of commitments to end the disease that kills more people than any other infectious disease—1.6 million in 2017, by the WHO’s count.

The event drew high-profile global health and TB leaders including WHO Director-General Tedros Adhanom Ghebreyesus, South Africa’s Minister of Health Aaron Motsoaledi and the Russian Federation’s Minister of Health Veronika Skvortsova, as well as a crowd-pleasing surprise: a tenacious TB survivor from India.

Médecins Sans Frontières, however, noticed all the leaders who were not in the room. “Not a single head of state from Europe or North America bothered to show up, even though all donors have signed on to end TB … how and with what remains to be seen. Distressingly, we didn’t have the 30 high-burden countries; they couldn’t even walk across the hall,” Sharonann Lynch, HIV & TB policy advisor for the MSF Access Campaign, told GHN after the HLM. Out of 193 UN member states, fewer than 30 leaders attended, MSF noted in a statement released after the meeting adjourned that threw some cold water on the optimistic promises at the meeting’s close. 

The WHO resolution that capped the HLM laid out world leaders’ commitments to ensure care for 40 million people with TB by the end of 2022 and preventive treatment to protect 30 million people from developing TB. The participating heads of state and leaders agreed to mobilize $13 billion a year by 2022 to implement TB prevention and care, and $2 billion for research. They also agreed to take firm action against drug-resistant forms of the disease, build accountability and prioritize human rights issues, such as the stigma around TB that still prevails in many parts of the world.

“It was very distressing to hear countries make empty promises to end TB, the leading infectious disease killer in the world, without even bothering to show up,” Lynch told GHN. “This means the opportunity to drag TB from the shadows, where it suffers from a lack of a political spotlight, was a failure; it did not grab the attention of the people who could make the most difference—the heads of state from high-burden and donor countries.”

Lynch singled out some notable champions. South Africa, for example, “which proposed the high-level meeting in the first place, treats more people with newer drugs than any other country, and made a commitment to drop the injectable drug to treat MDR-TB even before the WHO came out with its recommendation.” But she pointed out that the promises to date center on ending TB globally, without any national commitments … which “means everyone is responsible and no one is accountable.”

MSF wants to see national goals like diagnosing 90% of people living with TB or treating 90% of people with active TB, in addition to upgrading research into drug-resistant TB. “We have the potential,” Lynch added, “to use newer drugs, and drop the painful injectable that people have to take every day for 8 months, which causes deafness and other horrible side effects.”

TB survivor Nandita Venkatesan can speak to that, and she did—bringing the audience at the high-level meeting to their feet. After a long struggle with TB, the injectable drug her doctors said would cure her left her deaf. She spoke out to make sure the HLM heard from a person affected by the disease and how it stole what should have been the best years of her young life. “Esteemed leaders, I can't hear you today, but I’ll make sure you hear me—loud and clear.” Her presence at the HLM illustrated powerfully how high the stakes are if leaders don't follow through.

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