It's time to curve the curve to #endTB

Although the governments of 193 countries pledged in 2015 to end TB by 2030, the annual global rate of tuberculosis decline was well below what was needed. The rate of decline of tuberculosis, which currently oscillates around 1.5%, is expected to catapult to more than 10% by 2025 in the world, to end tuberculosis by 2030. But some countries give hope; as Thailand, which has already achieved a tuberculosis decrease rate of about 10% (source: WHO World Report on Tuberculosis 2018). The number of cases of drug-resistant tuberculosis has also decreased by 13% in Thailand in the last year.

"We are trying to curve the curves towards TB control more abruptly by implementing WHO's TB control strategy. Thailand National Tuberculosis Program (NTP), MOPH [Ministry of Public Health] has come a long way in the fight against tuberculosis ", said Emeritus Professor Piyasakol Sakolsatayadorn, Minister of Public Health of Thailand, in an exclusive interview with CNS (Citizen News Service).

Coordinated and well-coordinated multi-sectoral action, coupled with strong commitment from key political leaders, has indeed made a difference in Thailand's fight against tuberculosis. This resulted in the government's approval of the national TB strategy in Thailand, with additional funding to support TB case finding through the latest molecular diagnostics and chest x-ray, particularly in the area of ​​tuberculosis. high-risk groups (such as people in prison).

The country has also developed Thailand's 2017-2021 TB Operational Plan. "This plan includes the following five strategies: (i) active TB case finding to ensure full coverage by TB screening in high-risk populations; (ii) reduction of tuberculosis mortality; (iii) capacity building of human resources for tuberculosis prevention, treatment and control; (iv) create a system to support the sustainable and strategic management of tuberculosis; (v) promote research and innovation for the prevention, treatment and control of tuberculosis, "explained Professor Piyasakol Sakolsatayadorn.

Recognizing the urgent need for new molecular diagnostic tools for the early detection of tuberculosis, new drugs to treat tuberculosis (including drug-resistant TB) and, possibly, a TB vaccine, the Thai government has also funded a national tuberculosis research network. "ThaiTurn") which aims to provide innovative tools and strategies to strengthen the country's response to TB control. In August 2017, ThaiTurn launched the first-ever national roadmap for TB research. The roadmap includes research priorities to address health system issues, as well as the prevention and treatment of multidrug-resistant TB.

"This roadmap is a vital plan to boost efforts to end tuberculosis in Thailand," Minister Piyasakol Sakolsatayadorn said at the launch of the roadmap. "Leveraging this prioritized research strategy, with the participation of all stakeholders, is expected to produce strategic innovations in patient-centered TB prevention and treatment, bringing us even closer together to provide a promising solution to the problem." tuberculosis in Thailand.

According to TB Alliance (Global Alliance for Drug Development TB), current TB drugs are not adapted to cope with the pandemic. TB treatment takes too long to heal, is too complicated to administer and can be toxic. New, faster, simpler and more affordable treatments are urgently needed.

Echoes from Dr. Soumya Swaminathan, who is WHO's very first scientific leader and former Deputy Director General of this United Nations global health agency. "Without new tools, the goal of eliminating TB will not be possible. And these new tools would mean a rapid, place-of-care diagnostic test that can be done in the field to detect and diagnose TB, a combination of drugs that would cure TB in a short period of time (1-2 months) , a better TB vaccine and a better strategy for screening and treating latent TB. These are the identified gaps for which research and development (R & D) is needed. I think it's really important to have a roadmap to be able to monitor progress and possibly end tuberculosis. "

However, the funding gap continues to slow the fight against tuberculosis. Funding is also becoming scarce for research and development of new diagnostics, drugs and TB vaccines. Countries like Thailand are using innovative and national financing mechanisms to bridge this gap. Thailand's domestic funding for tuberculosis control has increased by more than 200 percent between 2015 and 2017, an example for other heavily TB-affected countries that need to increase their national TB control budgets.

"Funding gaps do not just happen with Thai NTP [national TB programme]but these gaps, particularly R & D, still exist worldwide. However, we are trying to fill those gaps with the existing health system budget. An additional budget will be allocated to priority issues such as TB contact tracking, MDR-TB treatment and social support to improve treatment collaboration, "said Thai Minister Piyasakol Sakolsatayorn. "In addition, a multi-sectoral collaborative approach can also lead us to successful history. The budget framework was used to develop a national strategic plan and an operational plan, as well as to estimate the costs of the activities of the parties concerned, for example the Ministry of Justice in coordination with the Ministry of Public Health (tuberculosis screening and care of prisoners) and national authorities. Office of Sanitary Security (tuberculosis treatment and laboratory test). "

Inadequate health security increases the risk of diseases such as tuberculosis. In addition, fragile health systems threaten to reverse progress in TB control. The Thai model of universal health coverage (CUS) has been put under the spotlight. "With increasing emphasis on UHC, and knowing that TB outcomes are really dependent on the quality of your health system, national investments to strengthen and support health systems will ultimately fruit for the fight against tuberculosis, "said Dr Soumya. Swaminathan of the WHO.

Thailand to co-host United Nations high-level meeting on UHC

The next UN High Level Meeting (UNHLM) will be on UHC, with Thailand as co-facilitator, alongside Hungary. The President of the United Nations General Assembly appointed Vitavas Srivihok, Permanent Representative of Thailand, and Katalin Annamaria Bogyay, Permanent Representative of Hungary, to facilitate the facilitation of UNHLM on the CSU to be held 23 September 2019 on the theme "Universal health coverage: displacement". together to build a healthier world. "

Last year, at the United Nations General Assembly, country leaders gathered at UNHLM to end tuberculosis and adopt a political declaration on tuberculosis, which also calls for a progress report in 2020 and a comprehensive review by heads of state and government at a high-level meeting in 2023.

"Three key components – funding, action and accountability – will be critical to the success of this UNHLM TB initiative," Dr Suvanand Sahu, Dr Lucica Ditiu and Dr Alimuddin Zumla of the Stop TB Partnership in the Global Lancet rightly pointed out. Health special feature in the perspective of this year's World Tuberculosis Day.

Tuberculosis is curable and preventable, but it remains the leading infectious cause of death worldwide. It is high time to end tuberculosis!

Shobha Shukla and Bobby Ramakant, CNS (Citizen News Service)