ttention from global leaders to ending tuberculosis, the world’s deadliest infectious disease, is growing. And that’s very good news. As we mark World TB Day and eagerly await a U.N. meeting on TB in September, we must work to sustain this commitment and build upon it to truly achieve a TB-free world.
This is doable, but by no means easy. TB claims 1.7 million lives a year despite being curable for the vast majority of people who contract it. The disease is most concentrated in low- and middle-income countries where only 60 percent of all new cases are being identified each year.
According to the World Health Organization, approximately one-third of the world’s population carries the TB bacteria, with about 10.4 million of whom develop “active” TB each year. The disease primarily affects adults during their most productive years, greatly affecting the livelihood of families while also threatening already vulnerable economies in developing nations.
It’s a tragedy that only around two-thirds of the nearly 10.4 million people worldwide living with TB are identified. Not only do some 3.8 million people potentially face a preventable death, TB is transmitted repeatedly in the same places. This vicious cycle continues each year with more people unnecessarily contracting TB, fewer people actually knowing they have it, and nearly 2 million dying of the disease.
Ending TB requires political will. Specifically, the global community must unite around efforts to develop better tools to diagnose TB and get to the “forgotten” 4 million who have not been detected; build upon what we know works to prevent, detect, and treat TB; and enact universal health coverage that will help reduce the number of deaths due to TB and other infectious and noncommunicable diseases.
Ending TB also means addressing the growing threat of multidrug-resistant TB (MDR-TB). Globally in 2016, an estimated 600,000 people developed MDR-TB. While the most common form of TB infection continues to decline in the Eastern Europe and Central Asia (EECA) region, MDR-TB infection is dramatically increasing. Today, EECA countries account for 3 percent of the global TB burden, but bear 20 percent of the global MDR-TB burden. Russia is one of the top 20 countries being impacted by MDR-TB.
MDR-TB is much harder to treat than common TB and presently requires between nine and 24 months of hundreds of pills and painful injections with side effects such as loss of hearing. The current vaccine poorly protects children from pulmonary disease caused by TB bacteria and does not prevent latent TB from becoming an active disease. The need for a shorter treatment regimen, better treatment drugs, and ultimately a therapeutic or preventative vaccine are even more acute.
On top of that, the EECA region is also home to one of the fastest rates of increase in HIV/TB co-infection in the world. The number of people dying from HIV/TB co-infection is increasing at the rate of approximately 13 percent annually. In this context, it is more than frightening to consider that 1 in 8 new TB cases in the EECA region is HIV-positive.
The time has come for change.
Last November, a momentous meeting was held in Moscow focusing on TB. At that gathering, Russian President Vladimir Putin declared that more resources were needed in the fight against TB and said, “I am convinced that only together by closing the ranks will we be able to counter the threat which has acquired truly global character. TB still poses a serious health risk for people all over the globe.”
Putin’s words were timely given this September’s first U.N. high-level meeting on TB, which could very well be a turning point in fighting the disease. When the world leaders gather, we hope they commit to the resources necessary to make detection, treatment, and prevention available to all.
We remember the U.N. General Assembly special session on HIV/AIDS in 2001 — a meeting that transformed the global response to the disease and saved and continues to save millions of lives. We can do the same with TB in September. We must not miss this historic opportunity. Let’s seize the moment and end TB once and for all.
Eric Goosby, M.D., is the United Nations secretary-general’s special envoy on TB. Michel Kazatchkine, M.D., is the special adviser to the Joint United Nations Program on HIV/AIDS (UNAIDS) for Eastern Europe and Central Asia.