Tuberculosis (TB) is curable disease that has been known to humanity for thousands of years. It is now the top infectious disease killer on the planet, with 4,400 victims every day. Transmitted through the air, and largely targeting the lungs this disease caused by a bacterium infection. In 2015 more than 9.6 million became ill with TB and 1.5 million died, 400,000 of which were people living with HIV. In addition, 480,000 people developed multi-drug resistant TB (MDR-TB), with 39.5% of those cases resulting in death.
Of the 9.6 million people who developed TB in 2015:
- more than 58% were in the South East Asia and Western Pacific regions. India and China alone account for 35% of total global cases.
- Of the 300,000 global cases of MDR-TB, around 1/3 were in South East Asia, less than half of that number were successfully treated.
- 60% of cases and deaths occur among men, but disease burden among women is also high
- 1 million of which were PLHIV
- However, treatment rates remain high (86% of all new and reported TB cases)
In the Asia and the Pacific region, there are a number of high burden countries. These countries account for over 80% of global TB cases, and include: Bangladesh, Cambodia, China, India, Indonesia, Myanmar, Pakistan, Philippines, Thailand and Viet Nam. Data is also available on HIV/TB co-infection and and MDR-TB. Each of the above countries is also high burden in these particular categories and is joined by Papua New Guinea, as locations that require particular attention.
We need Global Fund: Louie’s tuberculosis story
The Global Plan to End TB 2016-2020 The Paradigm Shift is a blue print for the TB community to drive bold action and ambitious change setting actions and resources that are required over the next five years in order to end the TB epidemic by 2030, and end TB by 2035. The Global Plan will ensure that 29 million are tested, 10 million lives are saved, and 45 million are prevented from getting TB.
Key components of the Paradigm Shift including: changing the mindset; pursuing a human rights-based approach to TB; Broadening the approach to leadership and ensuring it is inclusive; adopting a community and patient driven approach to TB; innovating and modernising TB programming; Integrating TB into broader health system responses; Funding TB adequately; and, investing in socio-economic actions and interventions.
To ensure the right interventions, in the right locations and among the right populations occur, and the Paradigm Shift can be effective, it is critical to focus on key populations. For TB, key populations including: PLHIV, prisoners, miners, migrants and mobile populations, people who use drugs, urban and rural poor, and children.
Investment and financing at a business-as-usual rate, will not be sufficient to achieve the Global Plan to End TB. Consequently investment in TB must be scaled up. There is a compelling economic case for investing in TB, whereby return on investment for every US$1 invested in TB being approximately US$30, a greater return than other public health issues, including heart attacks, immunization and malaria.
Ending TB is dependent on the disease becoming part of the national agenda across Asia and the Pacific and transitioning toward a patient and community centred approach, fostering an enabling environment for education, diagnosis, treatment and care, as well as challenging stigma and removing legal and policy barriers to an effective TB response.
In Asia and the Pacific, civil society priorities also include:
- Initiating and developing a regional network of TB advocates and civil society organisations;
- Community health, drugs and human rights literacy;
- Expansion of rapid-testing technologies – to ensure people with TB are identified and can receive the treatment that they need;
- Investment in affordable MDR-TB drugs and sustainable access to these drugs, including under international trade and intellectual property regimes;
- Advancement of universal health coverage regimes that are inclusive of TB key populations; and
- Advocacy to governments to increase domestic financing of the TB response.