Organization calls for Increased Funding to fight Tuberculosis

Ahead of this year’s World Tuberculosis TB Day, marked on March 24, the Stop TB Partnership has called for an urgent and substantial increase of funding to fight TB in order to meet the goal of ending the disease by 2030.

The organization’s latest projections show that an average of US$19.6 billion per year will be needed over the next eight years for TB prevention and care, up from the pre-Covid-19 estimate of US$13 billion per year.

An additional US$4 billion per year will be required for research and development (R&D) of the new diagnostics, medicines and vaccines needed to end TB. This represents about four times what is currently available for the TB response (in 2020, US$5.3 billion was available for care and prevention and US$0.9 billion for R&D).

The year 2022 is critical for the global fight to end TB as the world faces a fast-running countdown to reaching the 2018 United Nations High-Level Meeting (UNHLM) TB targets, which the international community agreed to meet by the end of December. All projections show that the world is not on course to meet the UNHLM treatment targets set for 2022.

“We simply cannot continue to stand on the sidelines and watch while people around the world fall ill and die from a preventable and treatable disease,” Executive Director of the Stop TB Partnership, Dr. Lucica Ditiusaid.

 “We also cannot continue to accept what we accepted for years—every year having less than 40% of the funding need for the TB response. Now we are facing a disastrous funding shortfall, bigger than what we had expected. We not only need to step up efforts to meet targets set at the 2018 UNHLM on TB, but the TB response must also recover from the devastating impacts of the Covid-19 pandemic.”

Additional funding
The projected increase in the funding needed to end TB considers setbacks caused by the Covid-19 pandemic and related recovery measures, as well as the impact of years of funding shortfalls.

Such additional funding will enable TB programs around the world to treat 50 million people with TB, including 3.7 million children and 2.2 million people with drug-resistant TB. It will also enable faster R&D, including new and effective vaccines, which are essential if TB will end by 2030.

Reaching the joint goal of ending TB is feasible if countries step up their funding commitments. Countries of the G20, for example, which represent 50% of the global TB burden, had a collective GDP of US$66 trillion in 2020, which is projected at US$99 trillion in 2026. The Stop TB Partnership estimates that mobilizing only 0.01% of this collective GDP would make an additional US$6 billion available per year for the fight against TB now and US$10 billion per year by 2026.

“TB is an infectious and deadly airborne disease with drug-resistant variants, and it is in no one’s interest to continue to let it fester undeterred around the world. Each untreated TB infection can lead to 15 more infections per year. As we saw in 2020 with COVID-19, we can mobilize significant amounts of funding in a short time if people, including world leaders, take the disease seriously. We don’t demand anything out of the ordinary; we demand funds to secure access to proper diagnosis and treatment for all people. It is, after all, a basic human right,” Dr. Ditiu added.

TB in times of conflict
The new funding estimates come in the context of the ongoing brutal war in Ukraine, and experts expressed grave concern about the potentially devastating impacts on health services, including the TB response in the country and the region.

Ukraine is one of the top 30 high drug-resistant TB burden countries in the world, with one in three people having a form of TB that does not respond to the most potent TB drugs. In 2021, Ukraine diagnosed and treated 24,000 people with TB, including almost 5,000 people with multi-drug resistant TB (MDR-TB).

“The ongoing war is completely unacceptable. We all make tremendous efforts to have a better, healthier world and we celebrate every single person with TB treated with success and cured. And we see now lives being lost in hundreds in a blink. This must stop,” Dr. Ditiu said.

Ukraine has a strong national TB program, with its supply of TB drugs entirely financed from its domestic budget, diagnosis, and treatment available to all people in need nationwide and a well-organized civil society response.

While information from the national TB program indicates that a majority of people with TB are still receiving the care they need, having been provided with at least a month’s supply of drugs, some have already been forced to discontinue treatment due to lack of access to health care facilities.

The situation is volatile, and it is expected to worsen if more people are unable to renew their prescriptions in the coming months and if attacks on health workers and health facilities continue unabated.

“Whenever there is conflict or war, essential health services and care are disrupted, with devastating consequences for the health of affected populations, especially the most vulnerable,” Dr. Ditiu added.

“While attending to people’s immediate and basic needs is the absolute priority, neglecting to act on TB now may have grave consequences in the near future. Interruption of treatment will lead to the further development of drug resistance, the movement of populations, the closeness experienced in shelters and on the roads, and the drop of immunity will naturally lead to an increase in infections.”

Continued tuberculosis care services
With the war resulting in unprecedented numbers of internally displaced people as well as refugees to neighboring countries, it is critical that TB services are provided to all those in need, free from stigma and discrimination.

“TB is very sensitive, and if we broadcast information about its uncontrolled spread, we will stigmatize people who are already stigmatized, for people who are already in a very difficult situation,” Head of Department of TB Programme Coordination, Center for Public Health of the Ministry of Health of Ukraine, Yana Terleeva said.

“The issue of TB stigma is not only in Ukraine, but across Europe, so let’s focus on ensuring patients know where to go and have a desire to continue treatment. They have to be assured there is a reason to live, that they will go back to Ukraine, and they have to be healthy to help us rebuild. They need this optimism, to have this desire to live and continue living.”

Director of the Division of Country Health Programmes, WHO, Dr. Nino Berdzuli said “we urgently need to provide the support needed to ensure continuity of treatment for people affected by TB, as well as to equip neighboring countries with the tools they need for timely diagnosis and treatment of refugees,”

The Stop TB Partnership is continuously monitoring and assessing the situation in Ukraine and is coordinating efforts with partners to provide seamless supplies of additional TB drugs to Ukraine if this need arises. They are also assuring that diagnostics and medicines are reaching the neighboring countries for uninterrupted TB care of people in need. The organization is also repurposing existing grants to support immediate emergency and lifesaving medical needs.

PR/Nneka Ukachukwu