NEW YORK, U.S.A. – Heads of state will gather at the United Nations General Assembly here on Wednesday, September 26, for a first ever high-level meeting to end tuberculosis, expecting to fast-track action to combat the world’s biggest infectious killer. 

The UN High-Level Meeting (HLM) on TB is only the 5th time that the UN has called for a high-level meeting devoted to a health issue, gathering governments, partners, and stakeholders to make it a political priority to end TB and provide treatment and care to those affected. 

In the Philippines, particularly, there is a target to reduce by half the number of TB cases by 2022.

The Philippines is among 8 countries where two-thirds of 2017 TB cases were found, data showed. 

Current actions fall short

Tuberculosis is the world’s biggest infectious killer. An estimated 4,500 people die from TB every day. In 2017, TB caused an estimated 1.3 million deaths among HIV-negative people and an additional 300,000 deaths among HIV+ people. 

Global estimates show that 10 million people developed TB  in 2017 and over 4 million people miss out on TB care and treatment. Additionally, the cases of drug-resistant TB remain a public health crisis. In 2017, there were 558,000 people who developed resistance to rifampicin, the most effective first-line drug against TB. 

Country commitments to end TB are found in the United Nations Sustainable Development Goals (UN SDGs), the World Health Organization’s End TB Strategy, and the Global Plan to End TB 2016-2020.

However, current actions fall short of what is needed to meet the goal of ending TB. Investments in TB research and development are underfunded. An estimated US$1.3 billion annually is needed to accelerate development of new tools, like vaccines and improved diagnostics.

What to expect at the UN meeting

A high-level meeting is convened by the UN General Assembly, the main decision-making body of the UN representing all 193 member states. The decision to hold a dedicated HLM on a specialized topic like TB is taken in exceptional circumstances, with the purpose of reaching agreements on cooperation and solutions on important global issues among heads of state and governments.

The UN HLM on TB will only be the 5th time that UN has called for a HLM on a health issue. Other HLM devoted to health issues included: Special Session on HIV/AIDS (2001), UN HLM on Non-Communicable Diseases, Ebola, and Antimicrobial Resistance.

The UN HLM is expected to result in commitments from heads of state and governments outlined in a political declaration that will form the basis for the future TB response.

Key priorities in the TB response include: 

• A coordinated global response to end TB
• Substantially increase financial resources for TB research and development
• Measurable targets and commitments from governments and key stakeholders for 2020 and 2025
• An accountability system with regular monitoring and evaluation 

Role of stakeholders, advocates, and communities

The UN HLM on TB Coordinating Group, convened by the Stop TB Partnership and partners, has developed 5 Key Asks which will be the basis for advocacy on commitments in the Political Declaration on TB. 

Key Asks are priority actions that must be taken by governments and heads of state to achieve an agreed goal outlined and detailed in a declaration. 

The 5 Key Asks from TB stakeholders and communities are as follows: 

1. Reach all people by closing the gaps in TB diagnosis, treatment, and prevention
2. Transform the TB response to be equitable, rights-based, and people-centered
3. Accelerate development of essential new tools to end TB
4. Invest the funds necessary to end TB
5. Commit to decisive and accountable global leadership, including regular UN reporting and review 

Why the HLM on TB is important for the Philippines

The Philippines is in the list of 8 countries where two-thirds of 2017 TB cases were found: 

• India – 27 %
• China – 9%
• Indonesia – 8%
• Philippines – 6%
• Pakistan – 5%
• Nigeria – 4%
• Bangladesh – 4%
• South Africa – 3%

According to data from the Philippine Department of Health’s National TB Program, the burden of TB in the Philippines remains high.

Based on the 2016 National TB Prevalence Survey, there are about 1 million Filipinos with TB. Most of the TB cases are found among males and highest in the 45 -54 age group.

In 2017, there were an estimated 26,000 TB deaths. 

According to Dr Celina Garfin, the DOH National TB Program director, the top 3 most vulnerable groups of TB are males and smokers, elderly, and those that were previously treated.

“These groups are at risk because of lower immunity and are thus prone to infection and disease,” said Garfin. 

The 2017-2022 Philippine strategic TB elimination Plan (PhiLSTEP) serves as the country’s roadmap on TB elimination. 

Key impact targets for 2022 include: 

1. Reduce number of TB deaths by 50% from 14,000 to 7,000 deaths
2. Reduce TB incidence rate
3. Reduce to 0 the number of TB affected households that experience catastrophic costs due to TB

This will be done by finding TB cases more aggressively across the country, make TB treatment easier and more accessible and provide financial protection for TB patients. – Rappler.com 

Ana P. Santos is covering the UN High Level Meeting on Tuberculosis in New York with support from the Stop TB Partnership.