Washington, DC, Tuesday 23 October 2001

The second and final day of the first Stop TB Partners’ Forum, convened at The World Bank in Washington DC, was devoted to a ministerial-level planning forum and featured three important events:

1. Endorsement of the Washington Commitment to Stop TB;
2. Signing of a formal Memorandum of Understanding between the World Health Organization (WHO) and the Global Partnership to Stop TB on the roles of the respective partners in the Global TB Drug Facility (GDF); and
3. A high-profile press conference featuring financier and philanthropist George Soros, WHO Director-General Dr Gro Harlem Brundtland and Jo Ritzen on behalf of World Bank President James Wolfensohn.

Session Six was devoted to 'Opportunities to Invest in Stop TB'. Even the best-laid plans, such as the Global Plan to Stop TB GlobalPlanFinal.pdf, need funding. This session focused on the development of concrete, effective means of financing and evaluating results, and on the generation of new resources and activities, profiling specific opportunities to invest in TB control. Country presentations by the Philippines and Uganda highlighted real-life ‘lessons learned’. A video presentation showcased the groundbreaking work of the GDF, which was launched in March 2001 and is already delivering live-saving drugs to the first approved country recipients (see WHO Press Release on the first shipment of TB drugs to the Republic of Moldova available online at http://www.who.int/inf-pr-2001/en/pr2001-43.html).

One of the day’s highlights was a panel, followed by a press conference, on the Global Plan and Investments to Stop TB, featuring Mr Soros, Dr Brundtland and Mr Ritzen.

• Mr Soros, whose Open Society Institute (OSI) has actively supported TB control (e.g. in Russian Federation prisons) and is one of the sponsors of the Partners’ Forum, was generous in his praise of the Global Plan as a "detailed, concise and comprehensive master plan" that should serve as a model for others.
• Dr Brundtland, noting that "partnerships will be the future of global health efforts," called the Global Plan "a tremendously important and exciting" means to give TB patients access to effective treatment for their curable illness. She fully endorsed its four objectives: expanding DOTS to all people and all countries; adapting DOTS to meet the challenges of TB-HIV and MDR-TB; improving existing tools; and strengthening the TB Partnership. Dr Brundtland observed that the US$ 9.3 billion in total projected costs for the five-year period 2001-2005—and the US$ 4.56 billion resource gap—was "not an enormous amount in terms of global health, not even US$ 1 billion a year … insignificant in the face of the US$ 12 billion economic toll borne by poor TB-afflicted countries every year."
• Mr Ritzen, referring to the events of 11 September in the United States of America, commented that the world must realize that poverty is undermining not only health, but also peace. He lauded the Global Plan, pointing out that it was a "good fit" for World Bank lending, both in terms of human health and development policy and in terms of sound economic investment. Confirming the Bank’s involvement, he said, "We will have to triple our efforts over the next five years."

Immediately following the Press Conference, which was attended by some 50 persons, primarily accredited media representatives, Session Seven was devoted to fine-tuning the draft Washington Commitment to Stop TB, which then received unanimous endorsement by all participants. As a next step to implementing the March 2000 Amsterdam Declaration to Stop TB, the Washington Commitment calls for:

• Urgent and accelerated action against TB over the next 50 months;
• Intensified efforts to reach the 2005 global targets for TB control (e.g. 70% case detection and 85% cure); and
• Mobilization of additional resources through increasingly coordinated efforts.

The final document was produced and made available the same day (the final text is available online at WashingtonCommitment23Oct.01.pdf).

Session Eight comprised the third and final round of concurrent roundtables on resources and partnerships. The ‘Mobilizing New Resources’ track featured country presentations by Peru, China and the Democratic Republic of Congo. The ‘New Partnerships’ track provided the context for presentations by Viet Nam, Bangladesh and PhilCAT. The key partnership message was: with NGO involvement, we can reach more communities, increase access, streamline resources and enhance providers’ capacity.

Final copies of the Washington Commitment to Stop TB were circulated to participants during the Closing Session. Concluding remarks were delivered by WHO’s Director of the Department to Stop TB Dr J.W. Lee and the World Bank’s Jo Ritzen, the latter underscoring the importance of "delivering now on our promises and supporting country action."

Finally, addressing representatives of 18 of the world’s 22 TB high-burden countries, 9 developed country partners, 9 international organizations, and about 60 NGOs, Dr Lee (WHO) said, "Here we stand, together, some 200 strong, having just taken the next steps. We are well under way on our journey to realize the goals endorsed 18 months ago in Amsterdam and to make progress towards the 2005 targets of 70% TB detection and 85% cure. The results of this meeting will also move us closer to our long-term vision of a world free of TB as a public health problem. Visions require nuts-and-bolts actions and consistent follow-through. That is what we have been doing."

Highlights of the Washington Commitment Countdown

• Next 50 days (by the end of 2001). All TB high-burden countries to finalize concrete national plans, affirm commitment to the Global Plan to Stop TB and support the launch of the Global Fund to Fight AIDS, TB and Malaria.
• Next 50 weeks (by the end of 2002). All TB high-burden countries will achieve a minimum 35% DOTS case detection rate and establish TB control coordinating mechanisms. The GDF will provide anti-TB drugs to at least one million additional patients.
• Next 50 months (by the end of 2005). All TB high-burden countries will achieve a 70% DOTS case detection rate and maintain an 85% cure rate; scale up responses against TB-HIV and MDR-TB; develop a 2006-2010 Global Plan;
• Next 50 years (by the end of 2050). TB will be eliminated as a global public health problem.