Bill & Melinda Gates Foundation

How Can We Stop TB?

October 23, 2013

Today, the World Health Organization released its annual Global Tuberculosis Report. As with past reports, it offers a mixed outlook on where we stand in the struggle against one of humanity’s oldest foes.

On the positive side, WHO is confident that the world can achieve the 2015 Millennium Development Goal of reducing TB-related deaths by 50%. The number of people who fell ill with TB reached a new low last year, and the number of TB deaths declined from 1.7 million to 1.3 million.

These results underscore the progress we’ve made since world leaders declared TB a global health emergency two decades ago. Expanded access to TB diagnosis and treatment has had an impact.

But major challenges remain. One in three people who fall ill with TB still isn’t receiving the treatment he or she needs. And we still lack the tools, strategies, and resources to address the growing burden of multi-drug resistant TB (MDR-TB), which affected more than 450,000 people in 2012.

So what can we do to stop TB? Today’s report identifies five priorities:

  1. Reaching the three million people worldwide who aren’t getting adequate TB treatment by expanding access to quality testing and care services across the public and private sectors;
  2. Addressing the global MDR-TB crisis by mobilizing a political commitment to address the problem, especially from the leaders of the 22 countries that account for 80% of the world’s TB burden;
  3. Ensuring that everyone living with TB/HIV co-infection has access to HIV treatment;
  4. Increasing domestic and international financing for TB, including the successful replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which is the source of more than 80% of international TB funding in developing countries; and
  5. Accelerating the rapid uptake of new tools that can be effective in enhancing case detection and reducing the number of people who drop out of treatment.

We also need to invest in next-generation R&D to identify and develop new tools that can fundamentally transform the fight against TB, such as more effective drug regimens, diagnostics that can be used at local points of care, and a better vaccine.

In the past few years, there have been tremendous technological advances in TB diagnostics and drugs. GeneXpert is a revolutionary molecular test that can detect TB in less than two hours and determine whether a patient has drug-resistant TB.

We are also making measurable progress toward the development of new drugs. In December 2012, the FDA approved the first new treatment for TB in four decades, and the Global Alliance for TB Drug Development, the TB Drug Accelerator Initiative, and the Critical Path to TB Drug Regimens project are together supporting research and clinical trials to identify new drug regimens that could treat and cure all strains of TB more safely and in less time.

The recent MVA85A TB vaccine trial has also deepened our understanding of the complex immunology of Mycobacterium tuberculosis, pointing the way to promising new avenues for TB vaccine development.

As my colleague Jan Gheuens has noted, slow and steady will not win the race against TB. What we need are real R&D breakthroughs combined with a strong commitment from world leaders to ensure that these breakthroughs reach those who need them most.

In the past decade, we have laid the groundwork to change the way we fight TB. Now we need to follow through so that we can turn the corner on this disease.

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