World TB Day 2017: Getting closer to the promise

Alice Sagwidza Tembe, CNS Correspondent, Swaziland
Swaziland joined the world in commemorating the World TB Day this March 2017. In so doing, many stakeholders from both health and non-health sectors, as well as private and public sector, gathered in different regions, charging forward with renewed energy and commitment towards stopping TB. As Dr Mario Raviglione, Director, Global TB Programme of the World Health Organization (WHO) shared in a webinar organised by CNS, this is a critical time where all players need to come to the table.

TB, and more importantly multi-drug resistant TB (MDR-TB), has ravaged the world claiming over 9.4 million new TB cases and 1.7 million deaths each year. 85% of these TB cases occur in Africa and Asia. In Swaziland, statistics show that the country has one of the highest rates of both TB and MDR-TB. Moreover, 80% of the TB patients are also HIV positive. Medecins Sans Frontieres (MSF)-Doctors Without Borders- Swaziland team led by the General Director Guilhem Molinie, an international organisation, that has been working in the country since 2007, in the far to reach areas of Swaziland, has witnessed the journey of 2 or more years of treatment of MDR-TB with adverse side effects like loss of hearing, loss of eye sight and even loss of life. They are now seeing the shorter treatment regimen of 9 months phase and also the introduction of new drugs-Bedaquiline and Delaminid-after over five decades. Swaziland is already witnessing some promising results, with approximately 90% of patients on the new shorter regimen becoming TB sputum negative at 6 months. Swaziland definitely has something to recognize this year.

It was however interesting at such a point in the efforts towards stopping TB listening to Paul Jensen, Director (Policy and Strategy), International Union against Tuberculosis and Lung Disease (The Union) as he pointed out interesting political commitment changes happening globally. The United States of America, a big player in the mobilisation of resources, funding multiple projects across the world, is looking at cutting back by 28%. This will be an unfortunate transition. Dr Mario Raviglione, Director of WHO’s Global TB Programme, shared details about the WHO Global Ministerial Conference: ‘Ending TB in the sustainable development era: A multi-sectoral response’ to be held in Moscow in November 2017. As the world leaders prepare for this upcoming event, it is essential to focus on the critical factors at play, including, but not limited to, the following:
  •   The new developments in drugs for MDR-TB is just the beginning; it is an indication of new and better possibilities. The TB bacilli has evolved so many times and somehow evaded the intelligence of man-kind. It is time to step up and catch on the speed of change. Research has to remain a critical component of the response
  •  The response for TB requires resources and until everyone takes responsibility of the cost of response, the progress will be hampered. Understanding that if you have resources and fail to spare some towards the response, we all stand to lose everything in the end. As donor funds dwindle, there is need to expand national internal resources to forge ahead.
  • TB has no respect for national and international borders, creed, race or gender. In that respect the united response to TB and MDR-TB needs to rise above political, religious and economic differences that have stratified the world community.
  •  It is essential to note that TB and HIV control programmes, as well as other related illnesses and conditions exacerbating spread and development of TB, that are otherwise segregated into small silo projects dividing and conquering any efforts made towards stopping TB, need to be collaborated. A concerted effort with a united front will also minimize need for large resource bases for the work to be done.
Less than a decade ago when TB started mutating into its drug resistant forms, it became a sure death sentence. Coupled with the HIV scourge, the human race was indeed under threat as a species. In light of the journey so far, it is prudent to note that the hope for victory still remain in sight, the dark hour is brightening and it is now, more than ever, that efforts need to be combined and sleeves pulled up, to win the fight once for all.

Alice Sagwidza Tembe, Citizen News Service - CNS
March 28, 2017