Today, March 24th, is World TB Day. World TB Day commemorates the day that Dr. Robert Koch announced his startling discovery of the cause of tuberculosis (TB). The discovery was a breakthrough and brought new hope to sufferers. More than 130 years on, it remains the world’s leading infectious killer. 1.8 million people worldwide died from the disease in 2015, killing as many people every year as HIV and malaria combined. And yet, it is a neglected disease: largely ignored by donors, and under-funded by high-burden governments.
Figures released today demonstrate that the worst impact of the TB epidemic could be yet to come. Experts calculated the impact of the disease in a scenario where drug-resistant TB becomes the norm and countries struggle to prevent onward infection. They estimated that as many as
75 million additional people could die by 2050 due to the continued development of drug-resistant strains of TB. The global economic cost of the disease could total US$16.7 trillion.
Yet this damage can be averted. We often say that it takes a village to raise a child. To beat smallpox, and as we eradicate polio, we saw that it takes the world to come together to end a disease, from civil society to the highest levels of government. But for TB, that political support has been lacking. The Global TB Caucus was founded to build that support.
In 2014, a small group of committed members of parliament (MPs) launched the Global TB Caucus. Since then, the network has grown to more than 2,300 members in 130 countries. Led by its members for its members, Caucus members press their governments to improve response to the disease.
However, what has been underestimated for so long was the potential passion that MPs could bring to the fight against TB. MPs have family members who faced TB and lost; MPs have had childhoods stolen by the disease; MPs who have survived TB as adults; medical professionals who saw TB in their clinics; and MPs who remarked on seeing the catastrophic costs TB patients face that “people in my country tell me that TB is a disease of the poor, however, if you were not poor before you had TB, you certainly will be afterwards”.
To date, the Caucus has supported strong commitments from governments to address TB and antimicrobial resistance. These include increases in national TB budgets in Myanmar, Kenya, Ukraine, Vietnam and Zimbabwe, new legislation in Philippines, Peru, and Georgia, and new international support pledged in donors countries United Kingdom and Australia.
New partnerships between civil society, former TB patients, researchers and medical professionals, international bodies and concerned individuals have developed to support members of the Caucus in their country, and Caucus members join together to address regional and global issues.
One important event was held this week, a gathering of members of the Global TB Caucus in Berlin to discuss a crucial initiative to support the end of TB. The Berlin TB Summit was a meeting of parliamentarians from across the G20 hosted by the Global TB Caucus, the Stop TB Partnership, and the ACTION Partnership, along with German NGO, DSW. It was part of a series of events planned across the first half of 2017 to seize opportunities to ensure the inclusion of TB in the prioritisation of Antimicrobial Resistance (AMR) within this year’s G20 agenda.
The Summit discussed the critical role of the G20 in addressing the global TB epidemic, and particularly addressing drug-resistant strains of TB through the existing work-stream on AMR. Particular focus was devoted to the G20 countries that, between them, account for 92 per cent of global R&D expenditure and 54 per cent of all TB cases every year. This year, the G20 is considering steps to address the market failure hampering the development of new antimicrobials, including anti-TB drugs. The Global TB Caucus also presented a proposal of various actions that G20 leaders could take to tackle TB and other forms of drug-resistance.
The Summit also released new figures – over the next 35 years, projections have estimated that drug-resistant TB could claim 33 million additional lives in the G20, at a cumulative economic cost of US$10.5 trillion. The figures estimate the cost to the G20 to equal US$875bn a year by 2050, as an estimated 1 million people die from the disease each year in those countries.
TB is a complex disease that requires a complex solution – new drugs, new diagnostics, a new vaccine, new national and global investment, new legislation and policy changes. As TB gains momentum, the solution requires the participation of all individuals and organisations, from the science and research stage through to ensuring access to treatment.
The Global TB Caucus believes that the end of TB is in sight and that the only sustainable response to TB is one where a broad range of stakeholders, from civil society to socially-minded corporations are engaged, both in continuing to mobilise and sustain political accountability and by sharing expertise and best practice. This includes organisations that are often overlooked by the ‘development community,’ such as major employers whose staff and supply chains could be affected by TB, have a major role to play.
Establishing a platform for corporate engagement with major companies in the technology and health sectors and influencers in new and emerging markets, the Caucus aims to plot a new path for global public health by bringing together a network of leading thinkers, technology developers, private sector entities, philanthropists and public health experts, and is actively seeking additional prospective partners from private sector entities to engage with that have an interest in public health.
About the Authors
Sarah Kirk is the Head of the Secretariat of the Asia Pacific TB Caucus and was appointed to the role by members of the Asia Pacific TB Caucus following their inaugural meeting in Sydney in September 2015. Prior to working in TB, Sarah worked in HIV and sexual and reproductive health in the Government and NGO sectors in Australia, Swaziland, New Zealand, Kenya. She is currently based in Cambodia.
Angel Cheng is Advocacy and Communications Advisor for the Global TB Caucus. Prior to joining the Global TB Caucus team, Angel’s work was focused on stakeholder engagement, communications, brand development, and events production for First Nations groups, arts and culture organisations, professional organisations, and political campaigns in Canada. She is currently based in Suva, Fiji.
Notes on the data:
- The full report: The global economic impact of anti-microbial resistance research is available to download at https://home.kpmg.com/content/dam/kpmg/pdf/2014/12/amr-report-final.pdf
Background data on TB:
- 8 million people died from TB in 2015. It is the world’s leading infectious killer, responsible for more deaths each year than HIV and malaria combined.
- There were 10.4 million new cases of TB in 2014, over 60% found in just six countries: China, India, Indonesia, Nigeria, Pakistan, and South Africa.
- There were 500,000 cases of multi-drug resistant TB (MDR-TB) last year. TB is the only major airborne drug-resistant infection.
- Of the 10.4 million new cases in 2015, 4.3 million were not officially diagnosed or treated. These ‘missed’ cases are a major obstacle to tackling the disease.
- Since 2000 nearly 33 million people have died from TB, and 172 million people have fallen ill with the disease.
- At the current rate of progress, TB will continue to threaten global public health for another 180 years.
Image courtesy of Global TB Caucus