New global plan launched to #endTB in next 101 months

Shobha Shukla *

Despite the promise by all countries to end TB by 2030 (and India to end TB by 2025), decline in TB rates, deaths, and number of new infections, is not steep enough to meet the target. Lot more action (and investment) needs to urgently happen if we are to #endTB in next 101 months globally (and next 41 months in India). That is why, the global Stop TB Partnership has unveiled a new costed plan for the world to end TB, the second leading cause of death, after COVID-19, from a single infectious-disease agent.

The Global Plan to End TB 2023-2030 emphasises on a new global focus on prevention and control of this neglected, and perhaps the oldest, airborne disease that still remains a health threat for every person on this planet earth, infecting 10 million people killing 1.3 million of them every year.

The Plan outlines the priority actions that could save millions of lives through early prevention, diagnosis, treatment and care of TB with a total investment of US$ 250 billion between now and 2030. Of this, US$ 157 billion is for TB prevention and care, US$ 53 billion for vaccination once new vaccines are available, and US$ 40 billion to accelerate the development of new TB treatment regimens, diagnostics and a new TB vaccine.

As pointed out by Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, the proposed investment of US$ 10 billion in new TB vaccines (as envisaged in this Plan) is 10 times less than what was injected in the research and development for COVID-19 vaccines with a compelling sense of urgency and purpose. So it should be possible to have a TB vaccine by 2025.

TB response remains severely under-resourced

Even as the global TB response remains severely under-resourced, and people with TB continue to experience some of the highest out of pocket expenditures, mobilising US$ 250 billion dollars in the next 7 years will indeed be a daunting task. But as pointed out by Dr Paula Fujiwara, Chair of the Global Plan Task Force, the economic return on this investment by 2030 would be huge - US$ 16 for every US$ 1 invested globally, and as high as US$ 28 for every US$ 1 invested in low- and lower middle-income countries. At the same time, the cost of inaction could be high, if TB will to continue to kill between 4,000-5,000 people every day, and result in a global economic loss of US$1 trillion.

Sharing some of the Plan’s highlights during its online launch, Dr Fujiwara said that once implemented, the projected impact of the Plan is to get at least 95% of people living with TB diagnosed; 35 million people with TB to access treatment (including 3.7 million children and 2.2 million people with drug resistant TB); 35 million people to access TB preventive treatment by 2030; and to have at least one TB vaccine for widespread use by 2026.

In an interview with CNS (Citizen News Service), Dr Fujiwara highlighted some of the new issues that have been included in the plan - like “putting prevention and control of this airborne respiratory disease at the centre of pandemic preparedness and response efforts (keeping in mind that future pandemics are also likely to be caused by airborne respiratory infections); pushing for a much needed TB vaccine; addressing mental health issues in people with TB; looking at community/home based models of TB care and control; understanding the role of One Health in TB care and control; educating the community so it can advocate for resources for new diagnostics, medications and vaccine; and also educating the researchers to involve the community from the start and listen to their needs”.

Gender-responsive, rights and justice-based people centric approach to end TB

Dr Paula Fujiwara emphasised upon a gender-responsive, rights and justice-based people centric approach (and not a patient centric or person centric care) directed towards all those who are affected by TB, including communities, families, workplaces, among others.

Speaking at the online launch of the Plan, Obiefuna Arinze Austin, Executive Director, Afro Global Alliance Ghana and Vice Chair of Stop TB Partnership rightly pointed out that it is not only about mobilising resources but also about bridging the gaps in service delivery.

“TB response is largely bio-medically focussed. But there can be nothing for us without us (the community). It is important to ensure that involvement of TB affected community extends beyond service delivery. It is not just about case findings and raising awareness but also ensuring that targets are met. We were far behind meeting targets even before COVID-19. We must practice what we preach and ensure meaningful participation and involvement of civil society and affected communities,” he said.

In the words of Dr Fujiwara: “We cannot ignore a disease just because it has been relegated only to the poorest parts of the world. With our attention diverted - along with the absence of financial commitments - TB has strengthened its grip on our planet. But we can regain control and meet our commitments to end TB by 2030 as long as we assert our political will now."