Today, 24 March 2017, the World Health Organization joins the rest of the international community to commemorate World Tuberculosis Day. The theme for this year remains the same as last year: “Unite to End TB”, but with a special focus on “Leaving no one behind” in line with the UN Sustainable Development Goals (SDGs).
TB is still one of the top 10 causes of death worldwide. While the number of TB cases is declining globally, there were a staggering 10.4 million new TB cases estimated in 2015. Over a third of these are still not diagnosed and treated, or are diagnosed but not registered by national TB control programmes.
Every fourth new TB case is from Africa, which has 16 of the top 30 countries with the highest TB burden. Every third case of HIV-associated TB is from the Region, with 81% of notified TB patients knowing their HIV status. Compounding this, seven countries have high levels of multidrug-resistant TB (MDR-TB). Drug resistant TB continues to pose a serious challenge because of the lack of adequate laboratory capacity to detect it, access to treatment and the long duration and prohibitive cost of treatment.
In 2014, countries in the African Region agreed to reduce TB deaths by 75% and new TB cases by 50% by 2025. To attain these new targets, countries and partners need to intensify efforts to reach, treat and cure everyone with TB. In particular, the poorest and most vulnerable people who are disproportionately affected by TB need special attention, along with underserved areas which lack access to basic health services.
These include migrants, refugees, ethnic minorities, miners and others working and living in risk-prone settings, the elderly, marginalized women and children in many settings. Factors such as malnutrition, poor housing and sanitation, and other risk factors such as tobacco and alcohol use and diabetes, affect vulnerability to TB and access to care. Furthermore, this access is often hindered by catastrophic costs associated with illness, seeking and staying in care, and lack of social protection, resulting in a vicious cycle of poverty and ill-health.
This will mean uniting together to achieve universal health coverage, involving more than Ministries of Health. It means creating opportunities across society – other government departments, civil society and communities, non-governmental organizations and the private sector - to be part of the fight to end the TB epidemic within our lifetime.
In addition, we need to take the fight against TB to the next level by harnessing the power of innovation. Experts are now looking at innovative approaches such as using digital technologies like, telemedicine and mobile health to achieve more coverage, more efficiently. For instance, digital X-rays can be emailed, allowing for remote support and real-time reporting as cases are being diagnosed. Some African countries are already using mobile phones and devices for recording and reporting case notifications. This is a much more efficient way to treat patients on time, and track those who have not shown up for appointments.
Doing things differently requires a commitment to strengthen health systems, improve communications and upskill health providers if we hope to attain the SDG target of ending the TB epidemic by 2030. We will need to build on our achievements made during the Millennium Development Goal era, and reposition resources for best results and impact.
The global community is realizing the very big challenge of achieving this goal. To this end, 2017 will see the unprecedented First WHO Global Ministerial Conference on TB in November in Moscow, Russia, and looking ahead, to the UN High Level Meeting on TB in 2018 at the UN General Assembly.
As we commemorate World TB Day, I call on Governments and other stakeholders to “Unite to End TB” by working closely together to address the scourge of this disease ensuring no one is left behind. This requires more investments in health care, and especially, making sure that no families are impoverished by the cost of treatment and care of infectious conditions like TB. WHO will continue to support countries to strengthen health systems to make this a reality.