Region-wide leadership to achieve a TB-free world is to be commended. Global support can accelerate grassroots progress

By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia

Leadership across the WHO South-East Asia Region to End TB by 2030 is formidable. It has also gathered pace. Last week’s Statement of Action on Ending TB – developed and adopted by the Region’s ministers of health and representatives at the ‘End TB Summit’ in New Delhi, India – shows exactly how and why.

Not only does the Statement of Action reiterate the Region-wide resolve to ‘bend the curve’ and accelerate action to End TB, as per last year’s ‘Delhi Call for Action’, but it also sets out a series of strategic priorities that will dominate TB-related activities in the coming year. Priorities like empowering national TB programmes and increasing resource allocations from domestic and international sources. Imperatives like ensuring each and every TB patient can access the best care possible and is provided social and financial protection while doing so.

Region-wide leadership to End TB – and the strategic and technical expertise behind it – is to be commended. Indeed, that leadership – which is occurring at all levels of government, society and within and among health systems – is of critical importance if the Region (and with it the world) is to become TB-free and achieve the Sustainable Development Goal target of ending TB as a public health threat by 2030.

Making this happen is one of WHO South-East Asia’s Flagship Priority Areas of work. The numbers show why. Despite the Region having around a quarter of the world’s population, it accounts for almost half of the world’s TB cases and 40% of the world’s TB deaths. TB remains the leading cause of death and lost productive years in the crucial 15-49 year age group, condemning millions of people to inescapable poverty. And though the proportion of cases of drug-resistant TB represents a fraction of TB’s overall burden (around 3%), they signify a substantial and growing health security threat.

Recent Region-wide progress is both significant and highly encouraging. In the past year alone Member countries have dramatically increased domestic funding for TB programmes. Two of them have done so by more than 100%. All Member countries have accelerated active case-finding. Many are doing so specifically among high-risk groups. Patient-centered policies have been developed and implemented, including direct cash transfers and nutritional support for persons suffering TB. And almost all Member countries have developed plans to engage civil society organizations.

As part of the Region-wide drive to End TB, Member countries should harness the power of cutting-edge tools and technologies, including for screening and rapid molecular testing. They should also ensure all persons that have had contact with a TB patient are traced and given the opportunity to be screened for the disease. Similarly, greater attention should be given to managing latent TB lest it become active, especially for persons living with HIV. Investing in research aimed at developing tools to prevent TB transmission (and that can be applied to large populations) should likewise be prioritized.

WHO’s support for these and other initiatives aimed at achieving a TB-free Region will remain steadfast, as it must. Technical assistance will be provided as and when requested. Regional and international platforms to workshop country strategies and overcome challenges will be convened where possible. And national and international partners will be mobilized and engaged to provide maximum support, including filling critical funding gaps.

To that end, maintaining the Region’s leadership, drive and momentum ahead of September’s High-Level Meeting on TB, which will occur alongside the UN General Assembly, is of vital importance. Doing so will ensure global recognition and support is harnessed, and the backing needed to accelerate progress at the grassroots is attained.

As the theme of this year’s World TB Day highlights, achieving a TB-free world means building leadership and commitment at all levels of society, from the highest offices of government to community health workers and volunteers. Ensuring communities themselves are empowered as part of the struggle against TB is likewise crucial. That is exactly what the WHO South-East Asia Region is doing – and will continue to do – until the 2030 target is met and the goal of a TB-free Region is achieved.

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Shamila Sharma
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