TB Response Rebounding From The COVID-19 Pandemic Downturn!

...World TB Day 2023 Marks the Start of a New Era: Yes! We Can End TB!

New Coalition of Leaders to End TB to be announced as preliminary data expected to show reduction in gap between estimated TB cases and diagnosed patients, to less than 3 million people in 2022 

GENEVA/VARANASI (24 March 2023)—The Stop TB Partnership today issued a positive World TB Day reset, ‘Yes! We Can End TB,’ to rally the international community to end tuberculosis (TB) by 2030. The Stop TB Partnership Board and partners convened for the first time during World TB Day in Varanasi, India—the country with the highest TB burden but also with high political commitment, ambition, hard work and a robust plan to end TB. On the sidelines of the One World TB Summit, the board and partners embraced a post-pandemic call to action that will see new efforts, research, tools and innovations put into practice.

“The theme of the G20 is a resolution for the shared future of the entire world,” said the Honorable Prime Minister Shri Narendra Modi at the One World TB Summit today. He underlined that it is realizing the resolutions of global good with the One World TB Summit.

“India’s efforts are a new model for the global war on TB. People’s participation in the fight against TB is India’s big contribution. India is now working on the target of ending TB by the year 2025. I would like that more and more countries get the benefit of all campaigns, innovations and modern technology of India,” added the Prime Minister. 

During the Board meeting, a high-level advocacy platform will be announced by the Stop TB Partnership: the Coalition of Leaders to End TB. Constructed on the leadership of India’s Prime Minister Narendra Modi, the coalition will include Heads of State and Government that are champions of the TB response at national, regional and global levels. Among the leaders whose representatives are negotiating this coalition are President Joko Widodo of Indonesia, President Lula da Silva of Brazil, President Cyril Ramaphosa of South Africa, and the newly elected President of Nigeria, Bola Tinubu. The Coalition of Leaders will be formally launched during the United Nations (UN) General Assembly week in New York City in September 2023.

In 2022, several of the high TB burden countries—including Brazil, Nigeria, India and Indonesia—diligently increased the number of people diagnosed and enrolled on TB treatment, reaching and exceeding the numbers seen before the COVID-19 pandemic. According to preliminary data from the Stop TB Partnership, in 2022 the gap between the estimated number of people with TB and those diagnosed and treated was the lowest ever—with less than 3 million missing people with TB. This gap was 3.2 million in 2019, 4.3 million in 2020, and 4.2 million in 2021.

Despite this progress, last year, as the COVID-19 pandemic ebbed, TB regained its tragic title as the world’s biggest infectious disease killer due to setbacks in diagnosis and treatment over the past three years. This year is critical as the international community prepares for the next UN High Level Meeting (UNHLM) on TB taking place in September 2023, the second such event held at the UN General Assembly.

“With the world regaining strength as the COVID-19 pandemic wanes, ending TB as a global health threat is a critically important goal,” said Dr. Lucica Ditiu, executive director of the Stop TB Partnership. “We have new innovations now to help us save lives—new diagnostic tools, shorter, less toxic treatment regimens, and new digital tools—and when we add the political muscle that the UNHLM will gather to the many dedicated health care professionals already in the front lines, ending TB looks increasingly possible.”

At the first UNHLM in 2018, 15 Heads of State and Heads of Government joined 1,000 participants in pledging to increase efforts to end TB. While the COVID-19 pandemic upended many of these commitments, the upcoming UNHLM on TB has already seen momentum in bringing the world together to renew this important goal. In fact, experts, scientists, donors, medical workers and advocates worldwide are already making up the ground which was lost due to the COVID-19 pandemic and economic downturn.

“It is absolutely inspirational to see so many nations stepping forward with their own national plans to end TB,” said Austin Arinze Obiefuna, executive director of the Afro Global Alliance in Ghana and vice chair of the Stop TB Partnership Board. “TB is a disease that hits the poorest parts of the world hardest. It will not simply go away; instead we need all governments to join us in stopping this disease from wrecking people’s lives, their families and their livelihoods.”

New tools and investments

In the past few years, new tools to combat TB have cleared regulatory approvals and entered the marketplace. Multilateral institutions and development agencies are working to make these innovations more accessible and available to the countries and regions most in need. These innovations include:

• Rapid molecular tests that can identify TB and resistance patterns in the bacteria;
• Shorter treatment regiments, for drug-sensitive and drug-resistant infections;
• New digital tools, such as AI enabled ultraportable X-ray systems for screening for TB; and
• Vaccine candidates that have advanced to phase 3 clinical trials.

Globally, investments in TB research and development have started to climb, surpassing US$1 billion for the first time ever. Advocates look to the coming UNHLM to boost this momentum and help governments and funding institutions reach the US$2 billion goal pledged at the first UNHLM, and further increase to US$5 billion per annum as estimated by the Global Plan to End TB. And there is growing political momentum on commitment and ambition from countries like India, Indonesia, Nigeria and South Africa to step up action at a time when new data shows that every US$1 invested in TB yields US$46 in benefits.
 
“What we need is quite simple, given that TB kills 1.6 million people every year,” added Dr Ditiu. “We need increased political commitments from all high TB burden countries, and significantly more financing so that we can meet all the challenges and embark upon a much faster path to new vaccines. We know what it takes to end TB; we need to roll up our sleeves and make it happen.”

Strong commitments and actions by high TB burden countries
India, the country with the highest TB burden, has displayed a strong ambition to beat back the disease under the leadership of Prime Minister Modi and strategic planning and execution of the Minister of Health of India, Dr. Mansukh Mandaviya, and his team. In 2022, 2.4 million people with TB in India accessed diagnosis and treatment, which is the highest ever in any year and signals that India’s TB response has now fully recovered from the impacts of COVID-19.

“Under the Prime Minister’s TB Free India Campaign, launched in September 2022, nearly 1 million people with TB have received commitment from individuals in society who will support them through their treatment journey,” explained Suvanand Sahu, the deputy executive director of the Stop TB Partnership. “This initiative is unique in the world and is a great intervention for TB awareness, stigma elimination, community ownership and crowd funding.”

India has a unique real-time TB information system called NIKSHAY, which is also linked to direct cash transfers to TB patients. In the last five years, using this system, US$260 million has been disbursed to nearly 8 million people with TB to support their nutrition.

The ambitious call from the Prime Minister to end TB in India has driven innovations in the areas of digital tools, diagnostics, data systems, community engagement and logistics. Twenty-five of these innovations, developed in the last two years, will be presented at a session at the Stop TB Board meeting on March 15 in Varanasi, India. Ownership for implementation has been decentralized to state, district and village levels, with awards given to recognize states and districts who are making rapid progress towards ending TB. People who have gone through the experience of TB are being empowered and made “TB Champions” for their contributions to end TB in their community. Currently more than 30,000 TB Champions are supporting the TB response in India.
 
“India is providing models to fight TB. Trace, Test, Track, Treat and Technology is the strategy we are implementing to end TB in India by 2025. India is also producing 80% of TB medicines. India is determined to end TB by 2025...India is ready to work shoulder to shoulder with all other countries and ensure a better world for future generations,” added Prime Minister Modi.  

Indonesia, with the world’s fourth largest burden of TB, also made significant progress in 2022. Almost three-quarters of the estimated TB caseload was diagnosed and treated, with the overall treatment success rate at 84%—the highest rates recorded for Indonesia. Key to the success of the National TB Program was the deployment of screening campaigns similar to what was used for COVID-19—pushed through thanks to the political commitment of President Widodo and Minister of Health Budi Gunadi Sadikin and his TB response team.

During the Board meeting, the Stop TB Partnership will also launch The Accountability Report of TB-affected Communities and Civil Society: Priorities to Close the Deadly Divide. This report follows up on the first ever global community report released in 2020, entitled A Deadly Divide: TB Commitments vs. TB Realities. The 2023 iteration was coordinated by the Affected Community and NGO Delegations to the STP Board and featured the mobilization of more than 1,000 civil society and affected community partners from over 90 countries. Their inputs are reflected throughout the report in over 30 country case studies and culminate in six calls to action that are required to end the TB epidemic.

“This report features unprecedented engagement and is written by people with lived experience of TB and therefore has a legitimacy that cannot be ignored,” said Dr. Ditiu.