Tuberculosis (TB) is an ancient disease that continues to plague humanity in the 21st century. In 2007, TB killed 1.8 million people. It is also the leading cause of death among people living with HIV. Despite these numbers, donors and policymakers have largely neglected global TB control efforts. This neglect has fueled the emergence of drug-resistant TB strains that threaten to undermine efforts to prevent and treat the epidemic.
Basic TB control is a highly cost-effective way to save lives, but outdated tools and methods have hampered progress. The vaccine currently used to prevent TB is 85 years old and is only effective against certain types of disease in children. The most commonly used diagnostic test is 125 years old, misses half of all cases, and cannot measure drug-resistance. The current first-line treatment regimen requires at least six months to cure patients and many TB patients must take from 13-17 separate pills a day. While the global TB community has greatly expanded its advocacy and fundraising efforts, adequate attention for TB remains sorely lacking.
To truly defeat TB, we must expand global efforts to prevent and treat both drug-susceptible and drug-resistant TB, develop and implement new technologies and methods, and elevate the disease on the global health agenda. Today, progress is being made. New drugs, vaccines and diagnostics are in development, and there is increased political awareness of the fact that TB poses a global threat.
There are also encouraging signs of political leadership from the US and Europe and other countries – particularly emerging economies with high TB burdens. High-burden emerging economies including China, Brazil, India, and South Africa – which together have 45 percent of the world’s TB and more than half of the world’s drug-resistant TB – have begun generating new ideas and commitments to tackle TB and prevent drug resistance. All of these countries have the capacity to support TB programs in low-resource settings.
However, awareness and funding for TB prevention, treatment, and research and development remains grossly inadequate. The Global Plan to Stop TB, developed by the Stop TB Partnership, projects a TB funding gap of $31 billion, including $22 billion for implementation and $9 billion for new tools. TB needs new champions, and governments, industry, NGOs and product development partnerships working to address TB need additional support and recognition for their efforts.