Stop TB Partnership

Closing Speech by Dr Gro Harlem Brundtland

Dr Gro Harlem Brundtland
Director-General
World Health Organization

Ministerial Conference on "TB and Sustainable Development"
Concluding Session
Amsterdam, 24 March 2000

Honorable Ministers,
Colleagues,
Ladies and Gentlemen,

The theme of the Year 2000 World TB Day is "Forging New Partnerships to Stop TB".

At this Ministerial Conference, I am joined by key partners from UN agencies, governmental as well as non-governmental organizations, donors and the private sector. All of us have come together with a shared concern to Stop TB and the unacceptable health, social and economic tolls which it exerts on the world today.

In 1998, I launched the Stop TB Initiative at the Global Conference on Lung Health and made a call for partners to join this important initiative. I am grateful that our call to partnership was heard.

Our challenge today is to decide where we go from here. How can we best grasp this opportunity to make a difference - to make a difference to tuberculosis and thus promote sustainable development?

The importance of health in overall sustainable development is being increasingly recognized around the world. Investments in health are acknowledged as investments in growth, productivity and security. Investments in health are essential for reducing poverty.

Ill health is both a cause and a consequence of poverty. As we have heard in the individual and family stories - illness can reduce household savings, lower learning ability, reduce productivity and lead to a diminished quality of life - thus creating or perpetuating poverty. Poor people are less well-nourished, have less access to information and less access to health care.

TB exerts its greatest toll on the poor. 98% of the deaths due to TB and 95% of the 8 million new cases every year are in developing countries, making the poor poorer.

On average, a TB patient loses three to four months of work time, equivalent to 20-30% of annual household income. Whole economies are also affected as 75% of TB patients are men and women in the most economically active age group. The workforce is reduced, productivity falls, revenues drop and markets are lost.

On the other side of the coin, better health can prevent or offer a route out of poverty. We have concrete evidence that developing countries which invest relatively more on health in an effective manner are likely to achieve higher economic growth. In East Asia, life expectancy increased by over 18 years in the two decades that preceded the most dramatic economic take-off in history.

In our global health work, we are prioritizing programmes on the basis of two key criteria -those which particularly affect the poor and those for which we have available cost effective solutions in hand. In short, we want to choose interventions which we know will have an impact.

TB can be cured and lives can be saved. People can go back to work. Children can go back to school. Economies can be revitalized. This is what sustainable development is about - access to opportunities.

Let us remind ourselves that we are committed to a development target of reducing the proportion of people living in extreme poverty by one half by the year 2015.

But, we must be strategic in our choices - choosing interventions which can have an immediate impact while those which have longer terms solutions are being worked out. We must choose interventions which can strengthen health systems and contribute to sustaining development.

We have heard Ministers agree that no one should be denied access to DOTS. This means that DOTS should be available to all who need it, wherever they live - whether they are young or old, man or woman, homeless or housed, jailed or free.

We have heard Ministers agree that DOTS gives hope to people with HIV/AIDS. They too should have access to DOTS - without fear of stigma and discrimination.

We have heard Ministers stress the need for adequate funding to Stop TB - whether from local government, central government or the international community.

We have heard Ministers describe how they have mobilized international resources, and used them in ways that catalyzed a stronger national response to enable more people to access TB treatment.

We have heard expression of commitment around the table - to a real increase in global and national responses.

I now ask - How can we best grasp the opportunity presented to us these past few days? What will we do differently from tomorrow, after we leave this conference. How can we all catalyze a difference in the lives of those suffering from TB and its devastating impact?

Let me make five final points about ways that we can take action:

• Let us make sure that TB gets the priority it deserves in budget allocations.
• Let us make sure that all people who need it can access treatment - regardless of whether they can pay for it.
• Let us encourage the global community to back country partnerships to Stop TB and respond positively to requests for support that benefits human development through tackling TB.
• Let us work together - in partnership - fighting the global epidemic - helping people all over the world to prevent TB.
• While continuing to expand access to DOTS, let us move urgently to tackle multi-drug resistant TB, while we can.

WHO and the other partners in the Stop TB Initiative are ready to take up the daunting challenge with you. We will work with you to establish indicators and monitor progress.

As we reach the end of our meeting, I would particularly like to thank the World Bank, UNICEF, UNAIDS, CDC, The International Union Against TB and Lung Disease, the Royal Netherlands Anti-TB Association, the American Lung Association, Soros and the Open Society, Rockefeller and the numerous other organizations at global and national level, who have worked so hard with WHO to put TB on the global agenda. I would also like to take this occasion to welcome the UN Development Programme to our growing partnership and encourage others to join this important Initiative.

As my colleague from the World Bank has reminded us, we will never realize our dream of a world free of poverty "unless we join hands to overcome major global threats to the poor and the marginalized". TB is such a threat, and we must, as the World TB Day theme calls for, "Forge new partnerships to Stop TB".

Thank you all.