While the recent WHO TB report gave some reason for optimism over a 1.5% drop in TB mortality, progress has been deemed insufficient. In fact, recent data reveals that the TB epidemic is far graver than we first thought and scores of TB patients continue to go untreated. It is thus that the term “waiting-to-die lists” was coined, as patients return home without treatment due to insufficient funds and drug stock-outs, consequently facing a death sentence and a threat to their families and communities. Moreover, in the European Region, multidrug-resistant TB remains an alarming problem.
The participants at Monday’s Stop TB Partnership meeting agreed that our current target of cutting TB deaths by 95% is ambitious. However, given that we know how to treat TB and effective medicine is available, it is sufficient funding and an adequate involvement of communities, which will determine whether we meet our objective. TB Research and Development has typically been neglected, receiving only 676 million in 2013, thereby leaving a 1.3 billion USD funding gap every year. Moreover, pharmaceutical companies are increasingly closing TB research programmes as these no longer appear profitable. According to Colleen Daniels from the Treatment Action Group “TB R&D is starting to look like a charitable endeavour with the Gates Foundation being one of its main backer, providing 27% of all funds”.
The EU as the world’s largest donor has failed to rectify the situation, generally punching below its weight in terms of TB funding. However, on a more positive note, Fanny Voitzwinkler from Global Health Advocates noted that the upcoming Latvian Presidency would raise the profile of the disease in the coming year by means of a Ministerial Conference at which a political declaration on TB and MDR TB in Europe would be adopted. Hope was expressed that the EU would start playing a more active role in the region and no longer shy away from its responsibilities.
Not only do we need greater funds for R&D but also for grassroots activities. HIV/ Aids was allocated sufficient funds to support the growth of grassroot communities and civil society in order to build a bridge between policy-makers and patients. In a similar vein, incorporating faith-based organisations and leaders into the TB treatment framework is seen as a positive way of involving local communities as shown in countries across the WHO European Region, including Azerbaijan, Bulgaria, Slovakia and Tajikistan. However, in order for such social frameworks to be established we need to first overcome the social stigma associated with TB which often prevents patients from seeking out treatment.
Even if TB is a difficult subject to discuss, South Africa is dealing with it in a positive way. Towards the end of the meeting, Wena Moelich introduced the concept behind KICK TB-HIV which entails distributing footballs to school children. However, these are no usual footballs, they depict the main symptoms of TB. By making children more aware of the disease and empowering them, Moelich is actively contributing to reducing South Africa’s crushing TB burden. “Adults will no longer change their behaviour, work with children, they will bring about the change you want to see in the future”, she noted with great optimism. Kick TB-HIV is not only determined to foster change in South Africa, but is actively targeting other nations which share its love for football. Brazil carried out a similar action during this year’s world cup and Russia will be invited to participate in 2018.
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