Interview with Rhéa Lobo, alternate member of the Board of Stop TB Partnership, as well as an international award-winning filmmaker with a background in health journalism and an extra-pulmonary TB survivor.
1. You have been personally affected by tuberculosis and you dedicate your work to fighting this disease. Why is this fight still important today?
We are dealing with the same issues with tuberculosis (TB) that I had when I first got the disease in 2008 and it is frustrating. I’m wondering if we are making any progress at all? There is a lack of new tools because there is not enough political will, financial commitment (whether it is in vaccines, diagnostics or drugs) and accountability. As a result, we are still using a 100-year-old vaccine that is ineffective in preventing TB, there is a tremendous amount of misdiagnosis, TB treatment continues to be long with debilitating side effects and there still is a lack of treatment literacy or support. We have had just a couple of new drugs made in 50 years – how is this even acceptable?
2. How do you think the covid-19 pandemic has impacted the fight against TB?
COVID-19 has drastically impacted the fight against TB and reversed over a decade of progress. TB deaths went up for the first time in over a decade to 1.5 million in 2020. In the same year, notifications were drastically down, and fewer people accessed life-saving TB care. According to the WHO’s Global TB Report, 9.9 million people fell ill with TB in 2020 but only 5.8 million people accessed care in 2020 (vis-à-vis 7.1 million people who accessed TB care in 2019). Which means we had nearly 4.1 million people who were undiagnosed or not reported in 2020!
TB’s infrastructure was used to accelerate the fight against COVID-19 – whether it is our doctors or diagnostic machinery. And now when the world is talking about pandemic preparedness for future pandemics and putting a lot of financial resources for this purpose, existing pandemics like TB do not fit into these conversations at all. Nor does TB feature in important conversations around Antimicrobial Resistance (AMR), even if it is a leading cause of AMR deaths. TB has suffered a great deal since the pandemic began in 2020 and it is about time TB gets its due.
3. In your view, what is the role of the Global Fund in the fight against TB and how is its new strategy going to help step up this fight?
The importance of the Global Fund in the fight against TB cannot be stressed enough. They are the largest funder of TB, yet it is important to note that they are not even meeting half of the requirements of the TB response – there is a huge gap from a funding point of view. According to the new strategy, TB continues to get only 18% of Global Fund resources up to $12 billion and this is unacceptable. TB accounts for 60% of deaths across the three diseases of HIV, TB and malaria – yet gets the smallest portion of the funding pie. It is unfair and unjust – the TB community has long been asking for an increase from 18% to at least 33%. We need a strong Global Fund to adequately support the fight against TB and we also need alternative funding mechanisms to fill other gaps such as in investments in TB R&D.
4. What do you think is needed to end TB as a global health threat by 2030? Do you have recommendations for world leaders?
If I could give one recommendation to world leaders, it would be to show your commitment and invest to end TB. We urgently need monetary resources both for implementation purposes as well as product development purposes for new tools in vaccines, diagnostics and drugs. This is crucial to keep the fight to end TB alive and to meet TB elimination goals by 2030. We are falling way short from global funding commitments made at the UN High Level Meeting on TB in 2018. We asked for a modest $2 billion per annum to fund ALL our research needs, we did not receive even half that value according to the Tuberculosis Research Funding Trends 2005-2020.
I’m putting my hope on the G20 for leadership and commitment. Let the numbers speak for themselves. Both are top infectious killers, COVID-19 killed 1.7 million people in 2020 and TB killed 1.5 million people. It is time we give people with TB the respect they deserve and the right to life and health. And it starts with investments.