The theme of this year’s celebration of World TB Day, “It’s Time”, is an opportunity to reflect on the advances that have been made in recent years but also on what remains to be done to end the scourge of TB in our Region and around the world.
In my message on World TB Day last year, I called on governments and civil society leaders at all levels to take leadership in combating the TB epidemic in our region. Following the high-level gathering of world leaders, policy-makers and civil society organizations at the UN High-level meeting on TB in September 2018, all stakeholders are now aware that an urgent global response is needed to a global epidemic. In the African region, TB is a major challenge to development, causes untold human suffering, and threatens the achievement of the 2030 Agenda for Sustainable Development.
The 2018 WHO Global Report indicates that the disease burden caused by TB is falling globally, in all WHO regions, and in most countries, but not fast enough to reach the first milestones of the End TB Strategy in 2020. In the WHO African Region, declining cases of TB cases (4% per year) placed it second among all WHO regions over the period between 2013 and 2017. Also, particularly impressive reductions (4–8% per year) have occurred in southern Africa (e.g. Eswatini, Lesotho, Namibia, South Africa, Zambia and Zimbabwe), following a peak in the HIV epidemic and the expansion of TB and HIV prevention and care.
To sustain these advances, current levels of investment by national governments towards TB care and prevention must be increased as they currently fall far short of levels required to end the epidemic by the end date of the Sustainable Development Goals. Likewise, efforts must be made to identify and remove the challenges that are slowing down progress, as well as adopt and roll out the most cost-effective policy options and interventions. Core TB control services should be funded from domestic resources, and universal health coverage introduced to ensure quality assured preventative, diagnostic, treatment and care services.
Building on the successes of the recent past and fulfilling the commitments made by our political leaders, national governments need to adopt policy and programmatic actions to foster a multisectoral response to end the epidemic. Within the broader context of a revitalized Primary Health Care system, these measures should include initiatives to look for and effectively treat all existing cases, and scaling up preventive treatment for high-risk populations, especially people living with HIV and child contacts of known TB cases.
To end the epidemic by 2030, we also need to ensure universal access to the WHO recommended rapid molecular tests as first-line tests for diagnosis for all presumptive TB cases, as well as to adopt the new WHO recommended drugs and drug combinations for treating drug-resistant TB.
Civil society organizations and community systems need to be strengthened to provide diagnostic support and care where patients live and work, as well as facilitate access to needed services, and to assist governments in scaling up services.
TB is at long last gaining a higher profile on the global political agenda, this should create more momentum to reach the targets we have set for 2020 and beyond; we look to our international partners for continued technical and financial support in the fight against TB and related conditions.
As Regional Director of WHO in the African Region, I re-affirm the commitment of my office and that of all my technical staff across the region to work with governments, other partners and communities to support the above actions towards ending the TB epidemic by 2030, if not earlier. It’s Time to end this suffering and bring hope to TB patients and their families.