The 50th UNION Conference has rounded up in Hyderabad, India. Being a major global conference on tuberculosis, the UNION brought together researchers, policy makers, programmers, and activists from around the globe. They met to talk about ending TB and other and lung diseases, share insights, and meet the ambitious targets to eliminate TB by 2030. Though the Conference has been dominated by the medical professions in the past, it has progressively opened up to more diverse groups and constituencies. This year, the conference saw a relatively higher participation of activists and representatives from the most affected by TB, and survivors of the disease. It was also observed that more community-related sessions have been accepted at the Conference, a confirmation from the UNION that things are changing with regards to the TB response. More of the agenda has also been dedicated to the intersections of human rights, community, and innovations in closing the gaps in TB service delivery and adherence. Also, for the first time, TB survivors met ahead of the conference during the Survivors Summit, to share their respective sessions at the UNION, and identify pressing issues in preparation for the Conference. APCASO and ACT! AP were also given the chance to speak and lead a number of sessions, including facilitating a community consultation organized by the WHO Civil Society Task Force, and co-organising sessions with partners.

A number of sessions during the conference tackled themes such as treatment access, stigma and discrimination, universal health coverage (UHC), and community development; in addition, particular sessions were focused on the challenges faced by specific populations, including men, transgender people and young people. The latter was especially relevant given the recently released Youth Declaration to End TB[1] facilitated by WHO in July 2019, showing that the conversation on young people and TB is ongoing and fruitful.

The UNION Conference was also an opportunity for researchers to make big announcements. One of them happened right before the conference, when a team of researchers working for GlaxoSmithKline Biologicals and Aeras published the final results of a clinical trial of their candidate for a Tuberculosis vaccine[2], M72/AS01E. The trial found that the vaccine, when injected in people with latent tuberculosis, halved the chances of the disease progressing to the pulmonary stage. There is still a lot to learn about the vaccine, and in particular when and how it would be made available to those who need it the most, but the results of the trial are nevertheless a major landmark, promising that an additional preventive tool will be soon available. Just as importantly, during the conference, Sanofi, Unitaid and the Global Fund announced a 66 percent price drop of their drug rifapentine, a great news as the drug is not only useful to treat active TB, but is also increasingly used in combination with isoniazid as a preventive treatment for people with latent TB. The use of the drug combination allows preventive treatment to be completed in only a fraction of the time, making it a lot easier for people to complete a full course. The price drop will allow more people, especially people living with HIV, to have access to this life-saving preventive drug. It is anticipated that the World Health Organization will provide new updates on the guidelines related to this preventive therapy development sometime soon.

Overall, the conference was bearer of good news. The toolkits and guidelines that were announced at the meeting shows potential in ending the TB emergency. However, many community-focused or -led events took place outside of the main building, significantly decreasing their visibility and the participation of the conference participants. While more room was given to civil society and TB-affected communities, such arrangements can make or break the difference in “Ending the Emergency”, as the theme of the 50th UNION, and that can only be realized if TB-affected communities are engaged and integrated in the TB response and in the UNION conference as equal partners.