A few weeks ago in parliament, the APPG on Global Tuberculosis (TB) launched a major new report that calls on the UK Government to take a two-fold approach to tackling the increasing public health threat of TB in the UK and worldwide.

‘Drug-Resistant Tuberculosis: Old Disease, New Threat’ identifies the main challenges facing the UK and the world and outlines a series of recommendations for swift action where the biggest impact can be made.

The report highlights concerns about drug-resistant TB  (DR-TB). Both developed and developing countries are witnessing a rise in DR-TB. Fifteen of the 27 highest burden countries are in the WHO European region, while in the UK DR-TB has doubled in the last decade. This is of great concern, not only because DR-TB is much more difficult to treat but also because, compared to ‘normal’ TB, it is much more expensive. The reports highlights that:

In the UK, treating a single case of DR-TB is at least £50,000 and in developing countries it can cost close to £6,000. This is compared to £5,000 (UK) and £15 (developing countries) for ‘normal’ TB cases.

In the report’s foreward, Andrew George MP (Chair of the APPG TB) made note of the fact that many consider TB to be a disease that has been consigned to the history books. The report reinforces the message that this is not the case. As Andrew George MP goes on to say:

The fight against TB needs a new sense of urgency and innovation; combined with sufficient funding – both in the UK and internationally – if we are to effectively tackle the ‘TB time bomb’.

Now is not the time to loosen the reigns in the fight against TB. We must do all we can to ensure that 1.4 million people per year do not continue to die of this preventable and treatable disease. In the report MPs make a number of recommendations to the UK Government which include calling for;

• A comprehensive strategy to combat TB in the UK;
• At least a doubling of the UK’s contribution to the Global Fund to Fight AIDS, TB and Malaria to address the threat of DR-TB in low- and middle-income countries;
• Continued investment in TB research and development (R&D) into new drugs, diagnostics and vaccines.

Visionary political leadership and increased investments into TB control programmes are exactly what is needed to fight the disease and tackle DR-TB; the report makes this clear. We hope the UK Government and leaders worldwide take note and do all they can to help save millions of lives.

We urge to you read the report. You can access the summary version here and the full version here.

The UK Coalition to Stop TB call on the UK government to use new funding contributions to the Global Fund to Fight AIDs, TB and Malaria to help fight tuberculosis and save millions of lives

The Global Fund to Fight AIDS, TB and Malaria has saved 8.7 million lives since it’s establishment in 2002. However, unless world leader make new commitments to replenish the Global Fund this year any gains made to date risk being reversed.

In the past decade, enough progress has been made in the fight against tuberculosis (TB) that makes us believe that an end to TB is possible in our lifetime. Much of this progress can be directly attributed to the Global Fund and the unprecedented support it has received from governments, foundations and private sector donors. Since 2002, it has dramatically changed the trajectory of TB in low-­‐ and middle-­‐income countries and has helped detect and treat 9.7 million new cases of infectious TB in the past ten years aloneii.

Despite this progress, TB remains a leading cause of death from infectious disease globally, second only to AIDS. In 2011, over 8 million people fell ill with TB, there were 1 million cases among people living with HIV and 1.4 million deathsiii.

These shocking figures are exacerbated by the fact that more and more people are being diagnosed with multi-­‐drug resistant TB (MDR-­‐TB) and, in some cases, extensively-­‐drug resistant TB (XDR-­‐TB). While standard TB can be treated relatively easily and cheaply, MDR-­‐TB treatment is toxic for the patient and can cost more than hundred times the standard amount. If we fail to act urgently we face the prospect of astronomical and unaffordable costs treating MDR-­‐TB, turning a curable disease into a death sentence for millions.

Increasing global mobility means that TB is something that affects us all and is our collective responsibility to fight. As Dame Sally Davies, Chief Medical Officer, states, “we have seen the importation into the UK of resistant strains of TB”. Indeed, in the UK, 8.4% of TB cases are resistant to a first line drugiv, while London has the highest TB rates of any capital city in Western Europev. We support her recommendations that drug resistance be taken seriously by politicians at an international level, including at the G8 and World Health Organisation (WHO).

One of the most effective ways of tackling TB is through financial support of the Global Fund. The Fund channels more than 80% of global aid funding for the detection and treatment of TB. Alongside its confirmed impact in saving lives, it been rated as a highly cost-­‐effective mechanism in a number of donor governments’ aid reviews, including the UK’s own. It is essential in the fight against the disease. Historically, the UK Government has been a leading example in meeting its pledges to the Global Fund on time and in full.

On World TB Day, 24th March 2013, we praise the UK Government for its continued commitment to the Global Fund. With a rising aid budget there are few better places to invest that have such high impact abroad that also benefit the UK.

We call on the UK Government to at least double its financial contributions to the Global Fund and leverage its leadership on smart aid spending to urge other donors to similarly increase their support for the Global Fund’s replenishment efforts throughout 2013.

World TB Day 2012 was marked on the 24^th of March. With a backdrop of a funding crisis in the battle against TB, Michael Gwaba a TB-HIV Patient-Advocate speaks about his personal experience of the Global Fund.

A $1.7 billion funding shortfall to fight tuberculosis (TB) over the next five years means 3.4 million patients will go untreated and gains made against the disease will be reversed.  Over 80% of the external funding that is going into tuberculosis control comes from the Global Fund and the Global Fund is facing a funding crisis.

In the week leading up to World TB Day 2012, RESULTS UK welcomed Michael Gwaba a TB-HIV Patient-Advocate from Zambia.  In an interview with Reuters he discussed his personal experiences of the Global Fund.

“I have seen the Global Fund work – I’m alive thanks to its investments in Zambia. But right now we now risk reversing the gains we have made in the fight against HIV/AIDS, TB and Malaria. Millions of people are now on TB treatment, HIV positive mothers are now able to give birth to HIV negative babies and malaria death rates have declined because of the increase in use of tools such as insecticide treated mosquito nets. But without new investment fast, those still waiting for treatment and care won’t be as lucky as I have been.  We have done well in terms of providing treatment for people with TB because of the funds from the Global Fund.  Our present worry is that if the Global Fund is not funded, that is going to affect all the work we’ve done within the country.”

To read the full article please see –

http://uk.reuters.com/article/2012/03/23/us-tuberculosis-funding-idUKBRE82M00A20120323

1st December 2010.

Today on World AIDS Day, millions of people living with HIV/AIDS are at risk of dying of tuberculosis, the world’s leading killer of people living with HIV. Despite all the gains achieved in the last twenty years through education and awareness, drug research and development of more effective ARV therapies, thousands of people living with HIV/AIDS continue to die from TB.

The UK Coalition to Stop TB with the UK Stop AIDS Campaign have today published an Open Letter in the Guardian Newspaper highlighting that we cannot effectively tackle deaths of people with HIV without also addressing those dying from TB. What is needed is the political will to help combat this dual epidemic on all fronts.

Please click here to read the full letter.

The Steering Group of the UK Coalition to Stop TB has now been formed and conducted their first meeting on 12 August 2010. During the first meeting a structural shake up of the Coalition took place whereby the working groups have now been disbanded and will be replaced by focal contacts for the key themes of: HIV-TB; TB in the UK; Resource Mobilisation; New Tools and Research with the purpose of forming ad Hoc ‘taskforces to tackle key activities coming up in the next few months. The Steering Group is currently in the process of developing a strategic work plan for the next six months (to May 2011), and will be introducing themselves, the strategic objectives and new work plan to members at the next quarterly meeting on 6 October 2010.

Steering Group members as of August 2010:
• Becky Owens (Aeras Global TB Vaccine Foundation)
• Mike Smith (APPG on Global TB)
• Aparna Barua (RESULTS UK) – vice Chair
• Morris Lab (Target TB) – Chair
• Mike Mandelbaum (TB Alert)
• Dr. Vanessa Graham (Individual)
• Kieron Hardman (Genus Pharmaceuticals Ltd)

For further information please contact the Coalition secretariat through aparna.barua@results.org.uk

24th March 2010 sees the celebration of WORLD TB DAY! With the launch of the UK Coalition to Stop TB’s new campaign ’TB: A Disease of the Past? Action Now!’ being launched today, the coalition aims to challenge the UK Government on the eve of a general election, to prioritise tuberculosis on the domestic and global health agendas, and take the lead in the international response to fight TB.

Gordon Brown MP, Leader of the Labour Party, Prime Minister

“Tuberculosis kills 5,000 people every day in the world’s poorest countries. But together we can stop it. The UK is providing unprecedented support to the Global Fund for AIDS, TB and Malaria, which has already helped to treat 5.4 million people with TB. As well as providing treatment we must stay ahead of the disease as it evolves and builds resistance. That’s why we’re investing £30 million to support the discovery and development of new and more effective drugs. We are determined to beat Tuberculosis.”

David Cameron MP, Leader of the Conservative Party

“World TB Day 2010 should prompt the world to focus on the urgent steps needed to reverse the spread of this disease. We need to build strong health systems in developing countries, tackle HIV/AIDS, and work to counter the growing threat of drug-resistance. In a globalised world, action to tackle killer diseases like TB, in the UK and abroad, is both a moral imperative and an urgent national security priority.”

Nick Clegg MP, Leader of the Liberal Democrat Party

“The rising incidence of TB, especially of drug-resistant forms of the disease, both at home and around the world is truly worrying. It’s the world’s most vulnerable people who suffer most from the disease – particularly those in sub-Saharan Africa and those living with HIV/AIDS. It is a scandal that, despite some progress, the Millennium Development Goal to halt the spread of TB will not be met on current form.

We have an enormous moral responsibility to people in developing countries; this is why we support the Global Plan to Stop TB. We’d make sure the UK pays its fair share towards implementing the plan. We also recognise the link between HIV/AIDS and TB – we would make sure DFID takes a comprehensive approach to addressing these diseases and would continue to promote research into new diagnostic tools, treatments and vaccines.”

With only five years remaining to meet the Millenium Development Goals (MDGs), almost 5,000 people will continue to die from tuberculosis every day. Now is the time to take action!

At 12pm on 24th March 2010 the UK Coalition to Stop TB delivered their TB Election Asks to No.10 Downing Street. Kibble Ngalauka, Executive Director of the Sue Ryder Foundation, Malawi and Aparna Barua, coordinator of the UK Coalition to Stop TB were present alongside Clare Shaw from Target Tuberculosis and Mike Smith, coordinator of the APPG on Global TB.

In November last year, with support from UK Coalition to Stop TB members, Dr Mark Porter recorded a radio programme focusing on tuberculosis in the UK.

Each week on ‘Case Notes’, Dr Porter explores a different medical topic with reports and input from experts.  RESULTS UK, TB Alert and the NHS were involved with recording this TB focused episode on 18^th November in Leeds. Interviewees included Natalie Winter, a patient advocate as well as TB specialists Rachel Dukes, Dr Ebere Okereke and Dr John Watson.

Case Notes will broadcast the TB episode on Tuesday 12th January at 9pm and Wednesday 13th January at 4.30pm.

For more information see http://www.bbc.co.uk/programmes/b00pkbmp

A report issued by the Stop TB Partnership finds that although important progress was made from 2006 through 2008 in reaching the milestones of the Global Plan to Stop TB many obstacles still remain.

DOTS, the cornerstone of WHO’s Stop TB Strategy, is available for 97% of the world’s population. Some 155 countries have adopted national strategic plans for TB control, including all 22 high-burden countries. The Global Plan’s treatment success milestone for 2008 of 83% has been surpassed — treatment success is now up to 85% worldwide.

Testing for drug resistance has increased almost threefold, and the proportion of people diagnosed with MDR-TB approved by the Green Light Committee increased from 7.3% in 2006 to 48% in 2008. Many countries have increased national collaborative activities to address HIV among people diagnosed with TB. Between 2005 and 2007 the percentage of TB patients tested for HIV in African countries with a high prevalence of HIV rose from 14% to 41%.

On the research front, nine vaccine candidates are in Phase I clinical trials, and by end 2008 three had entered Phase II trials. These are impressive gains, since the Plan calls for at least 20 vaccine candidates in Phase I trials by 2015. In diagnosis, new techniques have been introduced to referral laboratories that produce results in a few hours instead of weeks. On treatment, clinical trials by Stop TB partners on gatifloaxacin and moxifloaxacin may provide evidence for a shortened regimen for treating TB.

Despite these strides many obstacles remain. The detection of new smear-positive TB cases has slowed, suggesting that the 2010 milestone of a 78% detection rate will not be achieved unless countries take rapid and innovative actions. The great majority of people with multidrug-resistant TB are still not receiving effective treatment; and countries have not made sufficient progress in screening HIV-positive people for TB or increasing the numbers of people on preventive therapy.

Research efforts need to accelerate to develop and evaluate tests to detect active TB at the first point of care; to develop a robust pipeline of new drug candidates; and to reach the goal of a new vaccine by 2015.

Funding remains the most serious challenge. From 2006-2008, the financing needs for funding TB control worldwide was short by $US 1 billion per year.  The gap for research and development was approximately US$ 0.5 billion for 2007.

Photo courtesy Target TB

The Global Fund to Fight AIDS, Tuberculosis and Malaria’s Board of Directors has made an overall approval of grants with a two-year commitment of US$2.4 billion.

It is the ninth time the Global Fund Board approved new proposals to support programmes fighting the three diseases. The total two-year value of the programmes recommended for funding was US$2.4 billion; the second largest ever approved by the Global Fund, following a US$2.75 billion round in 2008. The Global Fund has now approved a total funding of US$18.4 billion for 144 countries since it was created in 2002.

“These grants enable countries around the world to address some of the main problems they are struggling with every day,” said Dr. Tedros Adhanom Ghebreyesus, Ethiopian Health Minister and Chair of the Global Fund Board. “These grants are based on the countries’ own needs and priorities and they are therefore a particularly effective source of financing.”

TB proposals did particularly well in Round 9 and received the highest level of funding to date – up to $US 1.5 billion over five years. A total of 34 new TB proposals were approved. Round 9 will provide for three times as much funding for drug-resistant TB as the previous round. The funding will support measures including securing adequate laboratory facilities and infection control measures and prevention of further emergence of drug resistance by ensuring that the essential elements of DOTS are in place.

The Global Fund Board decided to launch its next round of grants in May 2010. This round of funding will be considered for approval at a Board meeting to be held some time between November 2010 and January 2011.

“We are seeing a tremendous demand for funding,” said Michel Kazatchkine, the Executive Director of the Global Fund. “Countries are showing that they are able to effectively turn large amounts of money from donors into prevention, care and treatment of AIDS, TB and malaria, which in turn will save millions of lives. It also means that we need significantly more resources in the future. We may not be able to continue approving such amounts of financing and see continued progress in health in the coming years unless donor countries scale up their funding even further than what they have done so far.”

Sir John Crofton, the man who pioneered life-saving treatment for tuberculosis sufferers has died in Edinburgh at the age of 97.

Sir John led a team of scientists which found a cure for TB by using a combination of three antibiotics.

In tributes following his death, he has been called one of the greatest physicians of the 20th century.

His work in combating TB – which came to be known as the “Edinburgh Method” – has saved the lives of thousands of people, and improved the health of millions more across the world.

Never one to slow down, almost to the very end of his life Sir John continued as an inspiring worker in the field of tuberculosis and tobacco control. Sir John was Honorary President of UK Coalition to Stop TB member TB Alert, for whom he fundraised tirelessly.

Click here to read a full obituary.