Union President calls for change at UN High Level Meeting to End Tuberculosis

The Union’s President, Dr Jeremiah Chakaya Muhwa, addressed the high-level leadership at the first-ever United Nations (UN) High-Level Meeting (HLM) on Tuberculosis (TB), held yesterday, 26 September in New York.

He spoke on a multi-stakeholder panel chaired by Prof Isaac Folorunso Adewole, Nigerian Minister of Health, and Dr David Sergeenko, Georgian Minister of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs. The keynote address was delivered by philanthropist Bill Gates, who urged action and commitment to TB.

Dr Chakaya made three proposals as he addressed the HLM: revolutionise prevention, increase demand for TB services, and create the space for engaging new partners through TB Prevention Month.

The full text of his speech has been reproduced in full below. Video of the panel is available here (Dr Chakaya speaks from 26.48 – 33.20).

Your Excellency Minister Adewole and Your Excellency Minister Sergeenko; Excellencies; Distinguised guests and fellow panellists, colleagues, ladies and gentlemen.

I’m very happy that today this panel is co-chaired by Nigeria, and Mr Gates has given the keynote address. This reminds me of events in 2006, when the president of Nigeria at the time, President Obasanjo, and Mr Gates launched the Global Plan to Stop TB. That was an important moment.

And I hope this moment will be even more important. I hope it will be historic.

I would like to tell you that I’m from Kenya. And in Kenya, we lose about 120 Kenyans every day from TB.

I was born in rural Kenya in poverty and where today poverty is still very rife. I live in a city where poverty remains a big issue. And in both my village and in the city in which I live, people have died of TB and continue to die of TB. Over the last 25 years, I have worked hard to end TB, as a TB clinician, as a programme manager and in various capacities with entities such as WHO, The Union, the Stop TB Partnership and the Global Fund, yet this disease has remained relatively unmoved.

We all know that poverty is the major driver of TB and influences other drivers such as undernutrition, harmful use of alcohol, poor housing and high-risk work environments.

We therefore know we will not end TB alone as the TB community, but we will do so when we are joined by partners beyond the health sector.

I would therefore like to share three proposals.

Number 1. I think we should lead a revolution in TB prevention.

We are doing so poorly in TB prevention. Among children under the age of five who are exposed to TB in their own homes, only 23% received preventive therapy last year. Only about one in three people living with HIV received TB preventive therapy last year.

We know that the highest risk of developing TB in within a few months following infection. Yet, among people in the entire world over the age of five who were exposed to TB in their homes last year, we only managed to pick out 103,000 people and give them preventive therapy: can we imagine only 103,000 people across 189 countries?

In 109 countries, we do not even have data on whether household TB contacts are given preventive therapy.

We had some good news a few days ago that a new vaccine in clinical trial shows a lot a promise. We must push with that momentum to develop a new vaccine because we need a revolution in TB prevention.

Number 2. We must increase demand for TB services—not just the supply.

And we should start with household TB contacts. We must honour the rights of these contacts. Every single one has a right to know their TB status, whether they are infected or have active disease, and should be able to make informed decisions about prevention and treatment.

This is where partners outside the health sector can help us. They can spread awareness of TB and they can create demand for TB services. We can start with building partnerships in sectors where TB drivers are present.

It is the local demand for TB care and services that will build more national accountability for progress.

Number 3. We must create opportunities for engaging those very partners.

We recognise World TB Day every year, a very important day for public education and for advocacy. When there is so little awareness of TB among the public, a day dedicated to advocacy is simply not enough.

I want to suggest that we declare the month of March as TB Prevention Month. By designating an entire month, we will have more time and opportunities for coordinated advocacy and outreach. We can officially designate the time and space we need to educate our leaders, engage partners, and mobilise our communities in the fight against TB.

We know that our heads of state are very busy, and they would have many reasons for not participating in World TB Day events. But if we have an entire month dedicated to TB they would have no excuses for ignoring TB.

I will close with this. In Kenya last year, my President, Uhuru Kenyatta, announced a new agenda called the Big Four Agenda. He is promoting national development by making progress in four areas: universal health coverage, food security, quality and affordable housing, and improved manufacturing to create jobs and economic growth.

If this agenda is successful, it would have a big impact on TB in Kenya. The Big Four Agenda is in fact an anti-TB agenda.

And with TB Prevention Month, we could align the aims of the TB community with the aims of the national government and all of the sectors involved in Kenya’s development, and develop collaborations that serve economic development and work towards ending TB at the same time.

So, in summary, let’s revolutionise TB prevention, increase demand for TB services, and create the space for engaging new partners through TB Prevention Month.

 

Thank you very much.

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