What are the major issues in the response to tuberculosis?
Tuberculosis is a disease of poverty: overcrowding, malnutrition, and unsanitary living conditions promote the awakening of the bacillus and the onset of the disease. We should remember that it is preventable and that it can be cured in the vast majority of cases, thanks to anti-tubercular antibiotics. However, it was the deadliest infectious disease in the world before COVID-19. Why? Because it affects the underprivileged and vulnerable populations of the poorest countries, and the resources deployed in these countries with a high incidence of the disease are far from sufficient. This health scandal is a tragedy for the millions of people affected.
What are the messages disseminated by Global Health Advocates (GHA) on tuberculosis?
In 2018, developed countries made commitments at a United Nations Summit in New York. They specifically related to treating 40 million people with tuberculosis by 2022, ending the pandemic by 2030, and raising $15 billion a year for research and development to achieve this goal. Two years later, due to a lack of real political will, it is clear that the investments do not match the commitments made. In addition, 12 months of the COVID-19 pandemic caused us to lose 12 years of progress in the response to tuberculosis, according to the latest data published by the Stop TB partnership.
The problem is that tuberculosis is of little interest to the pharmaceutical industry. Yet, 10 million new cases per year, according to the WHO, should be enough to justify significant investments to refresh treatment tools, most of which are obsolete, particularly given the multidrug-resistant form of the disease. As for the BCG vaccine, developed in France nearly 100 years ago, we now know that it is not effective in adults. Not to mention that a strategy to combat stigma against infected people and for the rights of patients has yet to be developed.
What does L’Initiative bring to the tuberculosis response?
I think that it helps to build innovative responses to the three major pandemics and to strengthen their impact on populations, particularly at a community level, an angle that is not sufficiently taken into account by countries. L’Initiative’s role is therefore crucial, especially as tuberculosis is still the poor relation of the three major pandemics.
“L’Initiative contributes to building innovative responses to the three major pandemics and to strengthen their impact on populations, particularly at a community level, an angle that is not sufficiently taken into account by countries. »
How could L’Initiative do more?
L’Initiative has supported or has made possible many innovative projects in the field. Let it be known! For me, efforts need to focus on raising awareness of L’Initiative’s work and its tangible usefulness in the response. The National Assembly has just adopted, at first reading, a law on development that sets in stone the importance of the response to the three pandemics, and an increase in official development assistance budgets has been committed to them. It is up to us to carry out effective advocacy so that the response to tuberculosis is not once again the most under-served.
The steering committee asked L’Initiative to work on the issue of community health stakeholder remuneration. Why was this request made?
Infectious diseases, and tuberculosis in particular, are closely linked to the social determinants of health—the conditions in which we live and work. From this point of view, community organizations play a decisive role: they make it possible to reach the target populations even in the most remote areas, to make them aware of good hygiene practices, to identify contact cases, and to combat stigma so that patients are not rejected and accept treatment. For all these reasons, their work deserves more recognition. It is a must. We need to strengthen their training and give them fair remuneration so that they can acquire real status. This is a real challenge for scaling up the tuberculosis response.