Tuberculosis: WHO, Global Fund Call For Mobilisation Of Funds As Resistance Rises

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Tuberculosis is now a renewed threat, with strains that prove resistant to multiple drugs and are transmissible and the potential to spread widely, according to the World Health Organization and the Global Fund, which are looking for US$1.6 billion a year to prevent the spread of the disease.

WHO Director Margaret Chan told a press briefing today that the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) provides the vast majority of international donor funding for tuberculosis (TB). Despite the progress achieved in stopping the illness, allowing millions of people to be successfully treated in the world, the global TB burden remains “enormous,” with the additional challenge of multidrug resistance, she said.

Multidrug resistance tuberculosis (MDR-TB) has been reported in 84 countries, Chan said. It is notoriously difficult to diagnose and to treat, she said, and the 20 to 24 months of treatment come at the cost of very expensive drugs, some of which are in short supply and have considerable side effects.

The emergence of multidrug resistance can be attributed to poor quality treatment, whether because people received too little treatment or did not take their treatment long enough, or are treated with substandard medicines, Chan said. The fact that MRD-TB can be transmitted from one person to another makes the issue even more pressing, she said, calling for investments “that this global epidemic deserves.”

Global Fund Urges Focus on Marginalised Populations

Mark Dybul, executive director of the Global Fund, said that over the last seven years, only 60 percent of MRD-TB cases were detected, as the system tends to miss the most marginalised populations. Political will is required to focus on those populations and dedicate resources from domestic budgets, he said.

Many of those people with MRD-TB cases from marginalised populations, such as prisoners, drug users and poor populations, live in middle-income countries, “countries that can and should, in fact, be tackling the epidemics,” he said.

While the Global Fund can support countries financially and WHO can provide technical help, “middle-income countries need to take on this epidemic and be functioning and funding their own response,” Dybul said, adding that the Global Fund is supporting them but is also financing low-income countries.

Dybul put a particular emphasis on Eastern Europe, which he said is a part of the world where both TB and MRD-TB cases are going up, in “frightening numbers” and largely in marginalised populations. “[G]overnments have not been willing to step up to their responsibility to deal with these marginalised populations,” he said, adding that “much better progress” was seen in Asia and “other places” around the same issues.

“While we are increasing our financing, we definitely need countries that can finance their own epidemics to welcome marginalised populations into the human family and start financing a response there,” he said.

Short US$ 1.6 Billion Per Year

There is a significant funding gap and an additional $1.6 billion per year is needed to do what is necessary to fight the tuberculosis epidemic and the MRD-TB epidemic,” Dybul said.

He called for a link between HIV and TB in low-income countries, in particular in sub-Saharan Africa, where HIV and TB “are effectively one disease.” The Global Fund will be “strongly pushing” for recognition of the link between the two diseases and the need for those two diseases “to be dealt with under one programme category,” he said.

R&D Funding Also Lacking

According to a WHO press release, “in addition to the US$1.6 billion annual gap in international financing for the critical implementation interventions above, WHO and partners estimate that there is a US$ 1.3 billion annual gap for TB research and development during the period 2014-2016, including clinical trials for new TB drugs, diagnostics and vaccines.”

The press briefing was called in advance of the World TB Day, on 24 March, which commemorates the day in 1882 when Dr Robert Koch discovered the mycobacterium that causes tuberculosis.

 

Catherine Saez may be reached at info@ip-watch.ch.

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