An upcoming UN high-level meeting dedicated to tuberculosis has raised expectations that 2018 can be a watershed moment in the effort to end TB. At the sidelines of the 71st World Health Assembly, the Global Fund spoke to health ministers from across the world, who expressed optimism that 2018 can be a turning point in the fight against TB as well as the effort to deliver Sustainable Development Goal 3, which seeks to ensure healthy lives and promote well-being for all.
At the UN high-level meeting, we are seeking the attendance of the heads of state. We want them to come personally. The issue of TB is clearly now beyond the capacities of ministers of health because there are too many political, economic and social determinants of TB. The first thing for the heads of state to do is to come in person. The second thing is for the heads of state to commit to the five asks I listed in my speech, one of them being to commit to use 0.1 percent of their gross domestic product for research and development on TB. We need new tools. If we do not get new tools, even if we increase the pace of what we are doing at the moment, we won’t change [the situation]. Once they attend and commit to those “asks,” we will go back and implement, and start mobilizing societies to join that effort. That is how we will begin to end TB.
The “five asks” presented by Dr. Motsoaledi at a BRICS health ministers panel discussion during the World Health Assembly are:
The UN high-level meeting is important. Any matter that merits the attention of heads of state is important. If countries are able to secure the commitments of heads of state and government, we can have a coordinated global response to the big challenge that TB continues to be. With political commitment, resources will be found. It means that accountability in countries will now be with the heads of state and government. It also means that the heads of state and government will want to follow up on what is happening, and the progress countries are making in dealing with the burden posed by TB. It is important to note that the high-level meeting is likely to yield increased financial resources. I hope that this will lead to saving millions of lives that are currently being lost because of TB.
India has been fighting tuberculosis for too long, and now it’s time tuberculosis comes to an end. Prime Minister Narendra Modi has called for India to end tuberculosis by 2025, five years ahead of the targets set in the Sustainable Development Goals.
We expect the United Nations General Assembly high-level Meeting to come up with new strategies to reach the vulnerable. We also expect technical input for more effective medicines so that we are able to curb the disease in a short span of time. As far as India is concerned, we are ready to share our experiences in terms of medicine, input and technical support. Prime Minister Modi has said that if our neighbouring countries want first-line drugs for tuberculosis, India will be willing to give that free of cost. We also expect other countries to take a clear political commitment, especially in neighbouring countries where the burden is immense. Those countries will have to come forward because there are countries which share a big burden of tuberculosis. India can be an inspiration for other neighbouring countries with a high burden. We would like to see high-burden states go for an aggressive strategy.
At the UN high-level meeting dedicated to TB, leaders and partners must come up with ways to help countries locate the missing cases of tuberculosis. There is a huge gap between the estimates by global health partners and the actual cases we are able to find on the ground. Finding the missing cases is critical to ending the disease.
On Sustainable Development Goal 3, Burkina Faso has launched a number of initiatives as we work to remove barriers to health care access. Access to health care services for the most vulnerable populations is essential to end the epidemics. The key ingredients that led to our success against HIV are: strong political leadership, significant domestic resources and solid community health systems. These are lessons we are applying to the other diseases to achieve Sustainable Development Goal 3. A council of experts has been formed within the ministry of health to monitor closely our progress and ensure we are on track with this goal.
At the UN high-level meeting, countries should come up with strategies to increase funding for TB, especially from local sources. Countries have relied a lot on international funding from partners such as the Global Fund. We need to ask ourselves, how are we going to fund these programs locally? Relying heavily on international investments is not good as it doesn’t guarantee sustainability. We are not saying that international partners should withdrawal their funds, but we must secure sustainability of programs by coming up with great ways to raise those funds domestically. In Swaziland, we are piloting this model with malaria, by inviting the business community to partner with us. We must do the same with TB. Another issue that should be discussed in the meeting is the taxing of tobacco products. Taxes can reduce access to tobacco and decrease the burden of disease in our health facilities. Additionally, the money we get [from the taxes] will support us to buy medicines and commodities we need to implement TB programs.
Leaders attending the high-level meeting in September have to agree on concrete actions to strengthen health systems and provide the tools that every country needs to contain and treat TB cases. We will lose the gains achieved in the fight against tuberculosis if we do not handle the health of migrant populations effectively. We are noticing an increased number of migrants infected with drug-resistant TB. That is the real threat. Countries in Central Africa, including Cameroon, are facing significant migration flows from the countryside to the cities but also between neighboring countries.
Universal access to quality health care is paramount in our strategy to achieve SDG 3. It is critical to ensuring that the most vulnerable populations—children and women – have access to essential health services. The key pillars of our plan include expanding prevention services for HIV, tuberculosis and malaria, addressing children’s malnutrition and the discrimination of people living with HIV. We look forward to 2019, which will mark the official launch of UHC in Cameroon.
Tuberculosis is a millennia-old disease. We need a firm political commitment from high-level officials who are in a position to make decisions that have a real impact on public health. Tuberculosis touches me very personally because I am a pulmonary disease specialist. Paraguay fully backs this meeting, and as a country, we are going to re-emphasize our commitment to eliminate tuberculosis by 2030. The Sustainable Development Goals are an opportunity to improve public health in a multi-dimensional way, bringing together all levels of governments, local communities, the private sector, NGOs, so we can also address the social determinants of health. Building better health is about putting people and communities at the center.