Meeting Highlights: The post 2015 Global TB Strategy, and why research will be needed to reach Zero TB

Over the next several weeks, we’ll be publishing some of the selected highlights of the 44th Union World Conference on Lung Health in Paris and some of meeting’s satellite symposia — beginning with the Stop TB Symposium: Accelerating impact: the transformative role of research to end tuberculosis, held on Wednesday 30 October, 2013. A more comprehensive report will be forthcoming. 
Mario-DSCN8466After the activists gave up the stage, leaving their signs and banners behind — where they would stand for the remainder of the symposium — it became clear that WHO’s Global TB Programme has already taken much of the activist’s demands on board, in setting their new target’s for 2035. But the Global TB Programme’s Director, Dr Mario Raviglione, believes that research will need to be accelerated to reach the new targets for “ZERO TB.”

“There is room for optimism,” he said, explaining that since the last Union conference, the Global TB Programme has been meeting with civil society and all the major stakeholders of TB to devise the new TB strategy post 2015’s TB-related Millennium Development Goals. “I’m glad to say we have the zero’s there — and that is something that all of us now have to support” he said, “but the news that has come in this week [from the Treatment Action Group’s 2013 Report on Tuberculosis Research Funding Trends, 2005–2012) is not good news.”

After small but inadequate gains in TB funding over the last seven years, this year, according to the TAG report “TB R&D investors reported a drop in spending that threatens to undermine the tenuous gains made since 2005.”

Projected decline in TB slideDr Raviglione showed the audience one slide that explains the rationale behind the new TB strategy (pictured to the right). It shows the current trend of a 2% per year decline in the incidence of TB… and the projected decline if countries would scale up existing interventions (one of which, notably, is universal health coverage).

“We believe it is possible to go to an average 10% per year, if it were possible in Europe half a century ago, it must be possible in the BRICS countries, and other middle income countries — many of the countries that are dominating the epidemic in the world.. Why not? There is progress in the world; there is development,” he said.

“However if we do not invest in research now, we are not going to the point in 2025, which is a milestone in our strategy. We are not going to get there with the weapons that we need to get to really pursue elimination of TB. And those are a new vaccine and new prophylaxis, besides of course new diagnostics. These are the two that are probably going to make the difference, with, of course, all the other essentials in place,” he added. In other words, these tools really need to be in place by 2025 to reach the new strategy’s goals which are:

  • A 95% reduction in death, and
  • A 90% reduction in incidence by 2035.

“These are very bold targets and they are reasonable enough to present to the World Health Assembly and have the ministers of health approve them,” he said in conclusion. “But we are not going to go very far without the backing of everyone in this room.” Further highlights to come

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