Milestones :: Perspectives – New global commitment to end tuberculosis

Milestones :: Perspectives

New global commitment to end tuberculosis
News release
17 November 2017 | MOSCOW/GENEVA – Today 75 ministers agreed to take urgent action to end tuberculosis (TB) by 2030. The announcement came at the first WHO Global Ministerial Conference on Ending Tuberculosis in the Sustainable Development Era: A Multisectoral Response, which brought together delegates from 114 countries in Moscow. President Vladimir Putin of the Russian Federation opened the Conference, together with Amina J Mohammed, UN Deputy Secretary General, and Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“Today marks a critical landmark in the fight to end TB,” said Dr Tedros. “It signals a long overdue global commitment to stop the death and suffering caused by this ancient killer.”
The Moscow Declaration to End TB is a promise to increase multisectoral action as well as track progress, and build accountability. It will also inform the first UN General Assembly High-Level Meeting on TB in 2018, which will seek further commitments from heads of state.

Global efforts to combat TB have saved an estimated 53 million lives since 2000 and reduced the TB mortality rate by 37%. However, progress in many countries has stalled, global targets are off-track, and persistent gaps remain in TB care and prevention.

As a result, TB still kills more people than any other infectious disease. There are major problems associated with antimicrobial resistance, and it is the leading killer of people with HIV.

“One of the main problems has been a lack of political will and inadequate investment in fighting TB,” added Dr Tedros. “Today’s declaration must go hand-in-hand with increased investment.”

The meeting was attended by ministers and country delegations, as well as representatives of civil society and international organizations, scientists, and researchers. More than 1000 participants took part in the two-day conference which resulted in collective commitment to ramp up action on four fronts:
[1] Move rapidly to achieve universal health coverage by strengthening health systems and improving access to people-centered TB prevention and care, ensuring no one is left behind.

[2] Mobilize sufficient and sustainable financing through increased domestic and international investments to close gaps in implementation and research.

[3] Advance research and development of new tools to diagnose, treat, and prevent TB.

[4] Build accountability through a framework to track and review progress on ending TB, including multisectoral approaches.

Ministers also promised to minimize the risk and spread of drug resistance and do more to engage people and communities affected by, and at risk of, TB.

The Russian Federation, host of the first Ministerial Conference to End TB, welcomed the Moscow Declaration. “Tuberculosis is a complex, multi-sectoral problem that requires a systemic and highly coordinated response to address the conditions which drive the disease,” said Professor Veronika Skvortsova, Minister of Health, Russian Federation. “The accountability framework we have agreed to develop marks a new beginning, and, with WHO’s support to coordinate and track progress, we expect the Moscow Declaration to lead us forward to the high-level meeting of the UN General Assembly in 2018.”
Ending TB means investing in R&D
Joint statement from Aeras, FIND, and TB Alliance
November 17, 2017
This week, as health ministers, diplomats and other representatives meet to discuss tuberculosis (TB) at the World Health Organization (WHO) Ministerial Conference in Moscow, millions of people are suffering from the disease. The governments around the world can and must end this suffering through a major and sustained investment in TB research and development (R&D).
There were 10.4 million new cases of active TB in 2016—of which only 6 million were diagnosed and notified. Drug-resistant infections are on the rise. There remains a dire need for better, faster-acting drugs, a new vaccine, and technologies that quickly diagnose TB and determine the degree of drug-resistance.
Science is not holding us back, funding and political will to implement is.
The WHO estimates that R&D budgets need more than US$1 billion annually to turn around the odds of patients potentially losing years of their lives to a toxic treatment course, missing the opportunity for treatment due to poor diagnostics, or contracting TB in the first place because of an ineffective vaccine.
The WHO also reports that despite accounting for about 2 percent of deaths globally, TB receives only 0.25 percent of the estimated US$265 billion spent worldwide on medical research each year.

Simply put, TB science is woefully underfunded. Governments must work together to dramatically reshape the investment landscape.

Today, the time needed to treat drug-resistant TB ranges from nine months to two years or more—and yet in common practice the success rate is only about 50 percent. The majority of drugs that these patients are given are probably not helping at all—but they are producing side effects, everything from nausea and dizziness to deafness and kidney failure. For some, the treatment can be worse than the disease itself.

A true point of care test is needed to find the 4 million missing patients every year, where and when they first seek care. New diagnostic technology is critical to ensure that the right treatment regimens are used—right from the start—to prevent the lengthy and arduous road to diagnosis and cure faced by many patients.

Making matters worse, there is no vaccine that can effectively play a major role in eliminating this disease. Today, the Bacillus Calmette–Guérin vaccine is the only TB vaccine available. It is nearly a century old, only moderately effective in preventing severe TB in infants and young children, and it doesn’t adequately protect teens and adults, who are most at risk for developing and spreading TB.

Progress has been made but we need a greater commitment. There are 12 different TB vaccine candidates in clinical trials today, a significant increase from 2000—when there were zero. Data from multiple mid- and late-stage efficacy trials will become available over the next 3 years, providing data that will help optimize and accelerate TB vaccine development. But it will take a significant increase in resources to achieve critical breakthroughs—and to reach success quickly
Similarly, only a handful of drug candidates were being tested in clinical trials. Today there are more than 30. Two new experimental treatments show promise—one that might be able to cure all forms of TB except for the most drug-resistant strains (known as extensively drug-resistant TB or XDR-TB), and another that might be able to cure XDR-TB. Both could take substantially less time and money than current treatments.

At first glance, the TB diagnostics pipeline looks healthy. However, emerging game-changers are at risk due to underfunding at the clinical trial stage. In addition, very few diagnostic candidates would address the most critical need—a point of care test for primary care facilities. Diversification of the point of care pipeline, and identification of new biomarkers are urgently needed.

While the meeting in Moscow will inform future discourse on TB, it must also serve as a springboard toward decisive action against the disease. TB is the world’s deadliest infectious disease and efforts to curb it remain underfunded. We are calling on governments to make major commitments to fund the R&D that will end TB once and for all.
Catharina Boehme, CEO, FIND
Jacqueline Shea, CEO, AERAS
Mel Spigelman, President and CEO, TB Alliance

Global Fund Appoints Peter Sands as Executive Director
14 November 2017  News Release
GENEVA – The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria today appointed a new Executive Director: Peter Sands, a former chief executive of Standard Chartered Bank who after a distinguished career in banking immersed himself in a range of global public health projects.

Sands, who is currently Chairman of the World Bank’s International Working Group on Financing Pandemic Preparedness, is also a research fellow at the Harvard Global Health Institute and the Mossavar Rahmani Center for Business and Government at Harvard’s Kennedy School, where he works on research projects in global health and financial regulation.

“Peter Sands brings exceptional management and finance experience, and a heart for global health,” said Aida Kurtović, Board Chair of the Global Fund. “At a time when we face complex challenges, his ability to mobilize resources while managing transformational change is exactly what we need. We expect him to take the Global Fund to the next level.”

Sands served as Chief Executive Officer of Standard Chartered PLC from 2006 to 2015, having joined the bank in 2002 as Group Finance Director. Under his leadership, Standard Chartered successfully navigated the turbulence of the global financial crisis in 2007-2009, continuing to support clients and counterparties throughout the worst of the financial stresses and without drawing on government support of any kind…

After stepping down from the bank in 2015, Sands deployed his skills and experience in international finance on global health. Sands served as Chairman of the U.S. National Academy of Medicine’s Commission on a Global Health Risk Framework for the Future, which published the influential report on pandemics entitled The Neglected Dimension of Global Security: a Framework to Counter Infectious Disease Outbreaks. Sands is also serving on the U.S. National Academy of Science’s Forum on Microbial Threats and Committee on Ensuring Access to Affordable Drugs. Sands has published articles on global health and epidemics in various peer-reviewed journals.

“I am deeply honored to join this extraordinary partnership,” Sands said. “Infectious diseases today represent one of the most serious risks facing humankind. If we work together to mobilize funds, build strong health systems and establish effective community responses we will be able to end epidemics, promote prosperity and increase our global health security.”…

As new Executive Director, Sands will oversee and guide the implementation of the Global Fund’s 2017-2022 strategy, designed to maximize impact against HIV, TB and malaria and build resilient and sustainable systems for health.

The Global Fund is a 21st-century partnership organization designed to accelerate the end of AIDS, tuberculosis and malaria as epidemics. Founded in 2002, the Global Fund is a partnership between governments, civil society, the private sector and people affected by the diseases.

The Global Fund raises and invests nearly US$4 billion a year to support programs run by local experts in countries and communities most in need. The Global Fund has been consistently rated as one of the most effective and transparent organizations in the development sector.

WHO welcomes appointment of new Executive Director of the Global Fund
14 November, 2017 – WHO welcomes the appointment of Peter Sands as the new Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Gavi welcomes new Global Fund Executive Director
12 November 2017 – Gavi collaborates with the Global Fund in the vast majority of Gavi-supported countries.