Approving Political Declaration, Member States at High-Level Summit Call For New, Effective Vaccine Against Tuberculosis with Chants of ‘End TB!’
Amid urgent calls for a new and more effective vaccine, Member States at the high-level meeting on the fight against tuberculosis (TB) approved today a political declaration reaffirming their collective commitment to end by 2030 the infectious disease which — although preventable and curable — claimed the lives of 1.6 million people in 2021.
By the political declaration, to be submitted to the General Assembly for adoption, Member States committed to urgently strengthen measures to reduce tuberculosis-related deaths, continue to support the World Health Organization (WHO) Multisectoral Accountability Framework for tuberculosis, and implement costed national tuberculosis strategic plans or health strategies with multisectoral approaches, recognizing that the disease affects populations inequitably and contributes to the cycle of ill health and poverty.
Opening the Summit, Dennis Francis (Trinidad and Tobago), President of the General Assembly, asked: “Why, after all the progress we have made — from sending a man to the moon to bringing the world to our fingertips — have we been unable to defeat a preventable but curable disease that kills over 4,400 people a day?” He called on stakeholders to use all tools at their disposal to advance science and innovation until a vaccine is found. “End TB! End TB!” he declared, to an impassioned audience who joined him in the chant.
Amina J. Mohammed, Deputy Secretary-General, pointed out that armed conflict, economic upheavals and climate disasters create a breeding ground for the spread of infectious diseases in a vicious cycle that perpetuates inequality, and urged States to prioritize tuberculosis in their national agenda. Sharing her personal heart-breaking story of losing her 50-year-old father to tuberculosis 37 years ago this week, she stressed: “What we need is a vaccine. Let’s end tuberculosis now. It’s possible.”
On that note, Paula Narváez, President of the Economic and Social Council, said: "We must have strong political commitment to the very highest levels.” The high-level meetings on health this week highlight the interconnectedness of universal health, pandemic preparedness and ending tuberculosis, she observed, spotlighting the Council’s important role in helping countries deal with global health challenges and defining practical guidelines through policy.
Tedros Adhanom Ghebreyesus, Director-General of WHO, also emphasized the need for a new vaccine, noting that the only licensed vaccine was developed more than a century ago. The WHO established a TB Vaccine Acceleration Council to facilitate the development, licensing and equitable use of new vaccines, he said, stressing: “We have an opportunity that no generation in the history of humanity has had: the opportunity to write the final chapter in the story of TB.”
Austin Obiefuna, Vice-Chair of the Stop TB Partnership Board, said that although the political declaration does not include elements of TB stakeholders’ “key asks”, which he brought to the United Nations four months ago, it does contain many important provisions. Voicing hope for its approval, he urged political leaders to ensure that, even when they return home, TB is never forgotten until it is collectively ended by 2030.
Echoing that, Marisol Touraine, Chair of the Unitaid Executive Board, expressed hope that “tuberculosis won’t be a one-day priority but will remain an everyday mobilization”. Warning that tuberculosis is increasingly becoming drug-resistant, she reported that more than 650 children die of the disease every day. Noting Unitaid’s work with partners to launch the first TB drugs for children and advanced pediatric diagnosis, she called on the pharmaceutical industry to renounce secondary patents and thus make innovations even more accessible to all.
Handaa Enkh-Amgalan, tuberculosis survivor and author of the book STIGMATIZED: A Mongolian Girl's Journey from Stigma & Illness to Empowerment, said: “‘Do not tell anyone’ — those were the words of my doctor when I was diagnosed with TB 12 years ago.” TB remains prevalent and highly stigmatized in many developing countries, especially for women and girls who are held to higher standards of health, well-being and beauty in patriarchal societies. Stressing that “stigma costs lives” as it delays detection and treatment, she urged world leaders to prioritize the provision of targeted support to affected populations to reduce TB stigma.
Following the opening remarks, the plenary segment commenced and continued throughout the day, while, concurrently, the Summit convened two multi-stakeholder panels.
In the morning panel, co-chaired by Karina Rando, Minister of Public Health of Uruguay, and Budi Gunadi Sadikin, Minister of Health of Indonesia, speakers highlighted the need to accelerate multisectoral actions and accountability to ensure equitable, high-quality, people-centred tuberculosis care, and to address determinants of tuberculosis in the context of universal health coverage.
Among the panellists was Binika Shrestha, Member of the National Youth Campaign against Tuberculosis, who described her diagnosis at 18 years old and the challenges of her treatment and its side effects. Urging public and private sectors to ensure access to the latest rapid test and treatment, as well as financing and investment, she stressed that survivors should not be viewed as passive recipients of health services but as valuable partners who can contribute to the fight against TB. Interventions should be developed in consultation with those individuals and communities, she said, declaring: “Because nothing for us, without us!”
Also on the panel was Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, who said a country stepping up its fight against TB gets triple benefits: saving lives; accelerating progress toward universal health care — because TB is the pandemic of the poor; and strengthening pandemic preparedness — because TB requires sophisticated molecular diagnostics and good disease surveillance, among others components. “This is a sort of buy-one-get-two-free strategy!” he pointed out.
Bertrand Pfouminzhouer Kampoer, Executive Director of For Impacts in Social Health and Civil Society Taskforce, gave an overview of the Francophone Africa Regional Adaptation of Map TB Assessment. Implemented in 12 French-speaking African countries, it has brought together a range of stakeholders for multisectoral action, as well as parliaments, parliamentarians and Government officials. At the global level, a group of civil society experts has been established to bring the voice of TB-affected communities to the work of the WHO, he said, pointing out, however, that such efforts must be strengthened at the regional and national levels.
In the ensuing discussion, speakers underscored the importance of implementing an inclusive and multisectoral approach to fighting TB, including drawing lessons from the COVID‑19 pandemic, with some sharing progress to that end, while others spotlighted challenges and identified key areas for action.
Many delegations spotlighted their successes in fighting TB, including Saudi Arabia’s representative who reported that, working with public and private partners and communicating the importance of early detection, his country was able to reduce TB incidents by 21 per cent and death rates by 12.3 per cent compared to 2018, putting it on track to achieve its goals in line with the global strategy.
Poland’s representative noted that many of the 1.5 million refugees fleeing the war in Ukraine who are in her country suffer from TB. The Polish Ministry of Health, in partnership with the WHO, has launched a comprehensive initiative to provide efficient and free diagnosis, treatment and care, as well as a dedicated hotline for refugees.
Civil society representatives also took the floor, among them, the representative of the Elizabeth Glaser Pediatric AIDS Foundation, pointing out that in 2021, only 44 per cent of children with TB were diagnosed. Member States must improve paediatric care and bring down TB death rates by funding TB programmes and integrating screening, diagnosis and treatment into other child health services.
In another tack, the representative of Movendi International highlighted TB’s link to alcohol as a risk factor, spotlighting two omissions in the Political Declaration, adding that addressing alcohol use is crucial for countries to end TB. Moreover, using the full potential of alcohol taxation to raise domestic resources and reduce alcohol use and harm is essential to help countries prevent and reduce TB. She urged Member States and the UN system to make alcohol policy the priority it clearly should be.
Pointing out that “TB is a social disease”, the representative of the International Federations of Medical Students underlined that addressing the social, economic and environmental determinants of TB must be done with the meaningful engagement of all sectors.
However, describing much needed progress, the United States’ representative reported that the United States Centers for Disease Control TB Trials Consortium and the National Institutes of Health, which lead clinical trials in the country and around the world to find shorter treatment regimens, recently identified the first new short treatment regimen in almost 40 years for the drug-susceptible TB disease.
In the afternoon panel discussion, co-chaired by Alexandru Rafila, Minister of Health of Romania, and Kalumbi Shangula, Minister of Health and Social Services of Namibia, speakers highlighted the need to scale up adequate and sustainable national, regional and international financing to enable equitable tuberculosis service delivery, adopt innovative strategies and develop new diagnostics, vaccines and medicines.
Sharing a civil society perspective, Jamilya Ismoilova, Regional Social Behaviour Change and Gender Advisor at Abt Associates Inc. in Central Asia, said that community engagement is key in the fight against TB. Community health workers are at the forefront of service delivery, but they are chronically underfunded. Governments must allocate more resources, including grants for community-based organizations and survivor groups, she said, urging developed countries to increase their international financing. A dollar spent on TB intervention could generate a return of $40 by 2050, becoming “an investment in hope and a chance for a brighter future.” Recalling how the world came together to develop COVID‑19 vaccines in record time, she said: “This is what we need for TB.”
On that, Mark Hatherill, Director of the South African Tuberculosis Vaccine Initiative, reported that “for the first time, a new effective TB vaccine is within our grasp” and will enter a large confirmatory trial, with results expected in five years. “If the protection is confirmed, the impact will be transformative,” he added, noting that over the past 25 years, it could have saved 76 million cases, 8.5 million deaths and $3.8 billion in treatment costs. Needed is a research and development strategy that funds all seven late-stage vaccines to reach their potential; replenish the pipeline for early-stage vaccines; and move the most promising. Currently, TB funding is less than a fraction of 1 per cent of the $100 billion committed to COVID‑19 vaccines, which produced a dozen vaccines in three years, he observed, calling for a quantum leap in annual investment.
Antonio Brito, Member of Parliament and President of the Brazilian Parliamentary TB Caucus, urged commitments be translated into bold action. He established a group of 214 parliamentarians committed to eradicating TB. In Brazil, a committee, comprising 90 ministries, businesses and other entities, was established to end TB. He is also leading efforts to create a legal framework and secure budgeting. This can be a model for all parliaments in the world, he said, arguing that engaging parliamentarians is an effective way to increase TB-related investment.
Adding to that, panelist Atul Gawande, Assistant Administrator of the United States Agency for International Development, said that TB has not been overcome, not because of a lack of solutions, but because of a lack of will. His country’s successful fight against TB has included screening, testing, tracing, preventive therapy and treatment. To enable rapid uptake of these solutions, the Agency has negotiated price reductions for diagnostics and treatment and worked to reduce the manufacturing cost while promoting technology transfer to Africa for local production. With 60 per cent of TB funds committed by 2027 expected to go to local organizations, the Agency is rolling out quick-impact projects and investing in game-changing solutions.
In the ensuing discussion, speakers welcomed the Political Declaration as well as WHO’s establishment of a TB Vaccine Acceleration Council to facilitate the development, licensing and equitable use of new TB vaccines.
On that, the Philippines’ representative said the development of vaccines could solve a dilemma for the high-TB-burden country. He expressed his Government’s willingness to participate in clinical trials, affirming that Manila will give the same level of dedication that it gave to make COVID‑19 vaccines available to the distribution of TB vaccines.
Several speakers from developing countries called for more financing to help their countries end TB, with Panama’s representative stating that in Latin America alone, about 850 people are diagnosed with tuberculosis and 90 others die every day, affecting the country’s development. No region should be left behind, he said.
However, noting “we have left people behind”, Mexico’s representative said that 200,000 people died in her country in 2022. Thus, a national TB programme for eradicating TB has been dramatically revised. Indonesia’s representative, as well, said that his country revised its national TB strategy to end TB by 2030.
Several speakers representing civil society called for greater political will and partnerships. The representative of Global Alliance for TB Drug Development said that his entity has developed a six-month, all-oral, 90 per cent-effective cure, with partners. This is a transformative therapy, he declared, insisting that innovations, including vaccine development, can have huge impacts.