Accelerating action to meet the SDG TB targets: the case for a UN High Level Meeting on TB in 2017

As scientists and public health experts from around the world gather in Liverpool for the World Lung Conference 2016, I wish to address you in my capacity as Chair of Stop TB Partnership Board and Minister of Health of South Africa.

I would like to respectfully ask my fellow Ministers of Health, Heads of Governments, partners and civil society organizations to join me and the members of the Stop TB Partnership Board to call for a UN High Level Meeting on TB in 2017. If we are serious about ending TB by 2030 as agreed by members of the UN through their adoption of the Sustainable Development Goals, we need to give Tuberculosis the right level of attention and engagement by the Heads of State and governments - and a UN High Level meeting is the only way we can achieve this!

As a result of advocacy, including through the United Nations, there is global recognition that antimicrobial resistance is a threat to both individual and public health. What is not often acknowledged is that AMR has its roots in the tuberculosis epidemic. As a result of our inability to deal decisively with drug susceptible TB in many countries, we now have significant levels of multiple and extensively resistant TB.

The progress reported in the recently released WHO Global TB Report 2016 is far from optimal - with only 132 000 people with drug-resistant TB (DR-TB) diagnosed (out of an estimated 580 000 new DR TB cases), and only 50% of those that started the life-saving DR-TB regimens are cured. As the leading infectious killer and the leading edge of the AMR challenge, the global TB community must do better in mobilizing an effective response to both drug susceptible TB as well as DR-TB, for all those suffering from this devastating disease.

It is our responsibility as leaders in public health to raise this issue and ensure we fulfill the right of our people to the best and newest available tools - diagnosis, medicines and treatment regimens.

I can share what we are doing in South Africa: we have rolled a high number of GeneXpert machines nationally, to allow for both more reliable susceptible TB as well as rapid diagnosis of Rif resistance. As the latest Global TB Report shows, the number of MDR-TB diagnosed and reported in South Africa has increased significantly from the previous year. We continue to strengthen the overall diagnostic and laboratory network in the country with increased coverage for conventional DST (following the initial Xpert testing), coupled with new molecular line probe assay technologies such as Genotype MTBDR plus (Hain test).

For the treatment of those diagnosed, we are using new drugs such as Bedaquiline and we plan to introduce the shorter MDR-TB regimens in January 2017.

Even if we have these new medicines, we must continue to push for better, shorter, less toxic MDR-TB regimens through targeted research. Our programme, in collaboration with U.S. Agency for International Development (USAID) will evaluate the efficacy, safety and tolerability of a six-month regimen (a combination of Bedaquiline and Delamanid with one to two other TB medicines) especially for patients with drug resistance to isoniazid, rifampicin and a quinolone. If successful, this could have a major impact on the MDR TB epidemic globally.

I hope that my fellow Ministers of Health will take action and share their bold steps to address TB and drug-resistant TB. And I challenge the entire TB Community to call for the United Nations General Assembly to address TB in a high level meeting in 2017. It is time to be united and end TB in our life time!