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Invest to End TB: Save Lives

The Stop TB Partnership has announced the theme for this year’s World TB Day as ‘Invest to end TB. Save lives’. With this theme, the Stop TB Partnership and partners are calling on all those involved in the fight to end TB to unite to ensure that inadequate funding for TB ends now.

TB deaths have increased for the first time in over a decade (Global TB Report 2021). In 2020, 1.5 million people died of TB and the Global TB Report 2021 estimates that almost 10 million people developed TB. Of these, only 5.8 million people were diagnosed and reported, increasing the gap of people missing TB diagnosis and treatment and risking further spread of the disease. These numbers are only expected to worsen in 2022 (The New York Times, 2021).

At the United Nations High level Meeting on TB in 2018, global leaders made political commitments to transforming the TB response to ‘be equitable, human rights-based and people-centered’ by ensuring that policies recognise human rights including for key populations, ensuring all people are facilitated to know their TB status and are provided affordable, accessible and equitable access to services and care, including TB drugs, diagnostics and vaccines.

However, only US$6.5 billion per year is currently available for the TB response which is less than half of the commitments made by world leaders four years ago (Stop TB Partnership, 2022). TB interventions are some of the most cost-effective of all public health interventions with every US$1 invested in TB prevention and care ensures a return of US$43 (Copenhagen Consensus, online).

TB prevention saves lives and reduces TB incidence. Yet, targets for TB Preventive Therapy (TPT) for all TB contacts (adults and children) and high risk groups, including people living with HIV reached only 29% of the global target of providing 30 million people with TPT between 2018 and 2022 (IMPAACT4TB, 2021). Civil society organisations and partners in South Africa are advocating for the release of updated TPT guidelines to  expand the use of short-course, rifapentine-based regimens such as 3HP in alignment with WHO guidelines, and include the even shorter 1HP regimen in future guideline revisions.

Effective TB infection prevention and control measures include promoting safe shared air within indoor spaces to reduce TB and COVID-19 transmission. Therefore, the COVID-19 response could be leveraged to strengthen the TB response by increasing awareness about adequate ventilation and mask-wearing by the public.   (Escombe et al., 2019; Howard et al., 2021).

Occupational health policies should be implemented to protect our frontline health workers. As recommended by Dheda et al (2021), health workers should be provided with fit-tested particulate respirators as these provide better protection against infectious aerosols than surgical masks. Increased political will and investment is needed to ensure TB prevention for health workers, patients and visitors and healthcare facilities and communities affected by TB.

We need increased financial resources for TB prevention in order to mitigate the devastating impact of the COVID-19 pandemic on the TB response.

5 Questions for the Twitter Chat:
  1. How can we advocate for increased funding to prevent TB?
  2. How can COVID-19 be leveraged to improve TB infection control measures?
  3. How can we invest in TB infection prevention and control to save lives?
  4. What role does TB Preventive Therapy play in investing to end TB?
  5. What can TB stakeholders do in order to increase investments in an equitable and human rights based TB response?