SUMMARY NOTES

UN GENERAL ASSEMBLY TB SIDE EVENT HELD SEPTEMBER 24th, 2021

OVERVIEW

On September 24th, 2021, the World Health Organization (WHO) and the Russian Federation collaborated on hosting a UN General Assembly side-event titled: “Progress and Multi-sectoral Action towards achieving global targets to end TB”. The side-event’s overall focus was on reviewing the progress towards reaching global TB targets, advancing multi-sectoral action and accountability, and discussing preparations for the 2023 UN High Level Meeting on TB. The event brought together a diverse group of participants and speakers, which included representatives of the WHO and UN Leadership, the President of the UN General Assembly, Health Ministers and national ministerial delegations, partners and civil society. The event was moderated by Dr Tereza Kasaeva, Director of WHO’s Global TB Programme.

The key call-to-action included an urgent increase in investments, improved multi-sectoral collaboration and increased engagement of civil society, communities and people affected by TB.

TOP 10 KEY THEMES

The first session was comprised of a ministerial panel. High-level speakers from 8 different countries highlighted the following key themes that have emerged since the last UN High Level Meeting on TB in 2018:

UNDERREPORTING OF CASES
Due to the pandemic and the associated disruptions to TB services coupled with the public’s fear of visiting health care facilities, there was a significant drop in the diagnosis and reporting of TB cases. Globally, reporting of TB cases fell by 1.4 million, from 7.1 million in 2019 to 5.8 million in 2020.
INCREASE OF RESISTANT STRAINS
The rise of resistant strains of TB, also known as multidrug resistant (MDR)-TB and extensively-drug resistant (XDR)-TB, continues to be of great concern, particularly among countries of the former Soviet Union, where more than 50% of previously treated TB patients have been diagnosed with resistant forms of TB.
INCREASE IN DEATHS DUE TO TREATMENT DISRUPTIONS
Across the globe, COVID-19 disruptions led to an additional 1.9 million people not having access to TB treatment in 2020. Reduced access to TB treatment has resulted in an increase in TB deaths. In 2020, there were 1.3 million TB deaths among HIVnegative people (up from 1.2 million in 2019).
TB DEATHS SURPASS HIV DEATHS
The global number of deaths officially classified as caused by TB (1.3 million) in 2020 was almost double the number caused by HIV/AIDS (0.68 million). For HIV/TB co-infected patients, there were 214,000 deaths in 2020, compared to 209,000 deaths in 2019, with most of these deaths occurring in Brazil, Russia, and Nigeria.
LACK OF FUNDING
Global spending on TB diagnosis, prevention, and treatment has dropped from US $5.8 billion to US $5.3 billion, which is less than half of what is needed to reach any of the global targets set forth for 2030.
PROVIDER SHORTAGE
There is a shortage of healthcare professionals in hospitals and health care facilities to provide TB services across the globe due to the pandemic. Many health care providers particularly in lower- and middle-income countries, such as Mongolia, are underpaid by up to 30%.
LACK OF ON-THEGROUND RESOURCES
Community-based health initiatives that work directly with those affected by TB, particularly in rural and remote areas, are significantly lacking staff and financial support, particularly in countries such as Indonesia.
LACK OF PATIENT REPRESENTATION
Patient advocates and those directly affected by TB are insufficiently represented during the policy making process on the local, federal, and global level.
LACK OF TECHNOLOGY AND ANALYSIS
There is a lack of digital health initiatives and tools, especially for diagnosing TB and for supporting realtime surveillance and patient monitoring. Additionally, analytical tools to properly analyze existing data is lacking.
MISSED TESTING OPPORTUNITIES
Additional bi-directional testing is lacking for patients who may come to healthcare providers for diagnosis and treatment of TB, but may also suffer from other co-infections such as HIV and diabetes. Vice versa,TB testing should be including as part of routine health screenings.

KEY PRIORITIES

KEY PRIORITIES FOR 2023

During the interactive panel discussion with key partners on their roles and contribution towards sustaining and strengthening multi-sectoral action and progress towards ending TB, the following key priorities for the 2023 High Level meeting were highlighted:

Continue to foster cross-sector collaboration.

Increase awareness for TB and reframe the narrative.

Decrease the funding gap, especially after the diversion of funds toward COVID initiatives.

Foster community inclusion in understanding pressing issues and finding solutions.

Increase efforts to restore TB services after the pandemic.

Implement wider testing and better diagnostic tools for both TB and COVID.

Conduct research for pediatric formulations of front line drugs.

Strengthen health care systems across the globe and make them more comprehensive.

Create stronger links to the broader global health agenda and learn from countries that have made progress in better integrating TB in their country-wide communicable disease and health strategies.

Share lessons learned between COVID initiatives and TB initiatives.

A CALL TO ACTION

A CALL TO ACTION

The UN General Assembly side-event effectively confirmed that tuberculosis prevention, diagnosis, and treatment has been negatively affected by the COVID pandemic. In 2020, TB was second only to COVID-19 as a leading cause of death from a single infectious agent. Looking ahead, modelling projections suggest that the impact of disruptions caused by the pandemic on the number of people developing TB and dying from the disease could be much worse in 2021 and 2022.

Unfortunately, the COVID-19 pandemic has not only halted current progress made toward reaching global targets, but it has significantly reversed years of progress in providing essential TB services and reducing TB disease burden. While there are some isolated success stories on the country and regional level, the global TB targets are now mostly off-track and severely lagging behind . It is therefore utterly crucial that in addition to the priorities brought forth by the participants during the side event, immediate attention should be placed on restoring access to and provision of essential TB services such that levels of TB case detection and treatment can recover to at least 2019 level.

While it is critical to have a set of key priorities identified, it is equally important to pair these priorities with concrete action items and initiatives. Of particular importance is identifying tangible outcomes and further identifying effective ways to measure success and progress of proposed actions on the local and country levels towards reaching the global goals and targets set forth for 2030.

We at the Mueller Health Foundation (MHF) remain committed to make a significant difference in addressing this deadly disease. The Mueller Health Foundation is particularly focused on supporting activities across the following key priorities: (1) increasing investments for novel research, (2) improved multi sectoral collaboration, and (3) increasing awareness of TB and providing greater visibility of civil society, communities, and people affected by TB.

MHF has taken active steps in closing the funding gap by providing more than $4 million USD towards grants that support research for the identification of shorter and more tolerable treatment regimens. We do this with the aim of ensuring that these medications remain affordable and accessible to patients around the globe.

Furthermore, MHF sees it as its duty and responsibility to join forces with other organizations from a variety of sectors and to work together to save as many lives as possible. This is exemplified through our collaborative activities with our partners from the commercial sector, where we focus on using innovative technology, such as blockchain and AI, to create a comprehensive platform that fosters collaboration, preserves authorship, and uses advanced analytics to scan existing research and data to come up with novel approaches to TB prevention and treatment regimens.

Lastly, MHF is actively committed to increase awareness around TB by creating thought leadership pieces, sharing important facts around the disease in our newsletters, infographics, and social media channels, and creating educational materials such as movies and videos for distribution to the general public. Currently, we are also looking at supporting initiatives that give a voice to patients and those affected by TB and to provide the survivors with a platform to share their stories and have their experiences heard and learned from.

Looking ahead and now more than ever, despite the setbacks from the pandemic, it continues to be our responsibility as a global community to work together and seize this opportunity to save the lives of millions affected by TB!

Source: UNGA Side Event: https://www.who.int/news-room/events/detail/2021/09/24/default-calendar/official-UNGA-side-event-on-TB-2021
WHO Global Tuberculosis Report 2021: https://www.who.int/publications/i/item/9789240037021