Tuesday, February 20, 2018
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Intensify efforts to end TB 

As part of renewed efforts to End TB, we need to return to core public health principles

 

 

Tuberculosis is a global public health scourge. In 2014, 9.6 million people worldwide were estimated to have fallen ill with the disease, while 1.5 million people suffered TB-related deaths. In the WHO South-East Asia Region, which accounts for a disproportionate degree of the global TB burden, the disease killed around 460 000 people while approximately 340 000 children contracted it. Though progress in combating TB has been steady, it remains inadequate: at present rates people in the South-East Asia Region will continue to fall ill, suffer from, and be killed by TB well into the future. 

Beginning this year, an intensified battle has been launched against TB, which aims to change this. The “End TB Strategy” aims to reduce TB deaths by 95% and cut new cases by 90% by 2035, thereby creating a “region free of TB with zero death, disease and suffering”. Though ambitious, this goal is entirely achievable. The strategy rests on three pillars: the importance of integrated, patient-centered care and prevention; the need for bold policies and supportive systems; and the value of intensified research and innovation. In practical terms, this means governments create and implement policies that address the social, economic and behavioural factors that affect TB care and control, and tailor these policies for society’s most vulnerable. In other words, it means better governance.

Governments must strive to ensure early diagnosis and treatment for those suffering from TB while managing associated illnesses. They must also provide adequate funding for TB-related programme and back them with unswerving political will. They must pursue research in order to gauge the effectiveness of the initiatives they are taking, thereby ensuring that public funds are used effectively and for the best possible outcomes. Importantly, governments must also alleviate the catastrophic expenses the disease inflicts on affected families – expenses that greatly diminish the incentive to seek care and stay the course of treatment. Poverty reduction, improved nutrition, and better living and working conditions will all make a significant difference in mitigating the burden TB poses. And they all require a society-wide change for the better. 

Still, the single most effective tool for countries in the South-East Asia Region to meet the strategy’s targets and end the TB epidemic remains increasing health coverage. TB disproportionately affects marginalized populations, and is associated with poor living and working conditions. Inadequate access to health-care services results in cases going undiagnosed, while weak, overstretched and inadequate health systems result in patients being unable to gain the care required to beat the disease. Countries in the region need to prioritize strengthening of health systems. By enhancing access to health-care services and delivering the highest attainable standard of care, governments will increase their ability to prevent, treat and eradicate TB, as well as associated illnesses such as HIV/AIDS. This will not only have positive health-related outcomes, but also contribute to future economic growth. The benefits are many. 

Civil society and community groups have a critical role to play in engaging with government to ensure that access to health care is increased and universal health coverage becomes a reality. Claiming the rights accorded to ourselves, our families and our friends under the International Covenant on Social, Economic and Cultural Rights is a duty that must be taken seriously, and one that we must all make good on. Lasting change requires our persistent advocacy efforts, and achieving universal coverage is most certainly worth the time.     

      

Beyond acknowledging the importance of increasing health coverage, ending the TB epidemic in South-East Asia – particularly its drug resistant strains – also demands greater cross-border cooperation. A number of the globe’s highest TB-burden countries are in the South-East Asia Region, which is also host to significant cross-border migrations. Enhancing TB prevention, care and control for people in all countries of the Region means working in unison to develop frameworks that guide cross-border management of the disease and strengthen access to care and treatment for the vulnerable. To achieve this, visionary leadership is needed, as is a collective realization that TB does not recognize national borders, nor does it care for citizenship categories. 

On World TB Day, and at the start of WHO’s intensified push to “End TB”, we have the opportunity to renew our collective resolve to End TB once and for all. This opportunity must not be missed.    

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