End-of-year statement from Dr Giuliano Gargioni, Executive Secretary a.i. of the Stop TB Partnership

17 December 2010 - Geneva - As 2010 draws to a close, it is a good time to reflect on the accomplishments and challenges the Stop TB Partnership has faced this year.

Few would argue that the crowning achievement of the past year was the development and launch of the Global Plan to Stop TB 2011-2015 - Transforming the fight - towards elimination of tuberculosis. This new roadmap - which follows on the Global Plan to Stop TB 2006-2015 while setting new and more ambitious targets - for the first time, identifies all the research gaps that need to be filled to bring rapid TB tests, faster treatment regimens and a fully effective vaccine to market. It also shows public health programmes how to drive universal access to TB care, including how to modernize diagnostic laboratories and adopt revolutionary TB tests that have recently become available.

I believe it is worth citing two remarks made on the occasion of the new plan’s launch on 13 October. WHO Director-General Margaret Chan expressed perfectly the timeliness and significance of the plan." There is an urgent need to scale up action against TB - 10 million people, including 4 million women and children, will lose their lives unnecessarily between now and 2015 if we fail," she said.

Vanessa Nkosi - a 14-year-old pupil at the Pholosho School in Alexandra Township, Johannesburg, where the plan was launched - brought a hopeful perspective that should inspire us all. "Please - stop TB in my lifetime," she asked the assembled officials and journalists at the press conference.

We have a plan - now we need to put it into action. We call on all our partners and friends around the world to commit fully to the new Global Plan. The challenge is to drive the political commitment and funding needed to achieve its goals.

Other highlights of the year included the following:

January: The Stop TB Partnership launched the TB REACH initiative and announced the first call for proposals. The main objective of TB REACH is to promote early and increased case detection of TB cases and ensure their timely treatment, while maintaining high cure rates within DOTS programmes. TB REACH encourages the development and application of innovative, ground-breaking and efficient techniques, interventions, and activities that result in increased TB case detection, reduced transmission and prevention of the emergence of drug-resistant forms of TB. As suggested by its name, TB REACH focuses on reaching people who have limited or no access to TB services. A second call for proposals, for funding wave 2, was launched earlier this month.

February: A World Bank Independent Evaluation Group did a programme review of the Stop TB Partnership, finding that Stop TB is the one of the best performing global partnerships in the health sector, based on an analysis of its relevance, efficacy, efficiency, governance, and management. Yet, the review stated, "the sustainability of its achievements will depend not only on the Partnership itself but also on its ability to successfully confront new challenges posed by HIV and drug resistance, on the complementary disease-control activities of its donor partners, and on the capacity of high-burden countries to sustain TB control."

March: At a press conference at UN Headquarters in New York on 24 March, World TB Day, the Stop TB Partnership announced that British R&B singer and songwriter Craig David would be lending his voice - which has helped him sell more than 13 million albums in more than 20 countries - to the global fight against TB.

His aim will be to raise awareness about TB among his millions of fans worldwide. "Music is a universal language. I believe that through people's love of music we can increase knowledge and understanding and support people affected by TB. I hope that people who feel inspired by my music will also feel moved by what I have to say about TB," Craig says.

On a more sobering note, during the week of World TB Day, WHO reported the highest levels of MDR-TB ever recorded and the pandemic continues unabated.

In WHO's Multidrug and Extensively Drug-Resistant Tuberculosis: 2010 Global Report on Surveillance and Response, it was estimated that 440 000 people had MDR-TB worldwide in 2008 and that a third of them died. Tuberculosis programmes, the report said, face tremendous challenges in reducing MDR-TB rates. But there are encouraging signs that even in the presence of severe epidemics, governments and partners can turn around MDR-TB by strengthening efforts to control the disease and implementing WHO recommendations.

April: Dr Jorge Sampaio, the UN Secretary General's Special Envoy to Stop TB, joined by legendary footballer and Goodwill Ambassador against Tuberculosis Luis Figo, made a two-day visit to Jordan. Their objective was to draw attention to TB as a serious public health problem in many countries of the region and the Islamic world, while highlighting Jordan's role as a leader in the fight against TB.

The visit was organized under the auspices of Prime Minister Samir Al Rifaai, in coordination with various organizations including the National Tuberculosis Programme; the Jordanian Football Association, under the chairmanship of His Royal Highness Prince Ali Bin Al Hussein; and the Office of the WHO representative in Jordan.

May: The Stop TB Partnership's Global Drug Facility (GDF) announced it had delivered 16.5 million anti-tuberculosis (TB) treatments since its creation in 2001. GDF's 13th Progress Report said that some 2.4 million treatments were delivered in 2009 alone.

GDF provides grants of free high-quality adult and paediatric anti-TB medicines to countries unable, through government or alternate funding, to secure the finances needed to purchase them. It also provides direct procurement services and in 2009 saw considerable growth in procurement of adult anti-TB medicines. GDF also opened its paediatric medicines for direct procurement by interested countries in 2009.

June: The Partnership announced the third round of grants from the Challenge Facility for Civil Society, with 21 civil society organizations across Africa, Asia, Eastern Europe and Latin America slated to receive grants ranging from US$ 5000 to $20 000. The Challenge Facility targets grass-roots civil society organizations that seek to help shape policy at local levels by giving a voice to people living with TB and those involved in its prevention, treatment and care. Proposals are selected by an independent committee composed of 10 representatives from the community affected by TB, NGOs from developing and developed countries and multilateral or technical agencies.

The activities of grant recipients are expected to result in resources for TB control, active community case finding and referral by the community, engagement with cured people to encourage TB patients to complete treatment and tracing of people who have interrupted their treatment.

July: It was a first at the International AIDS Conference--a protest march calling for no more deaths from TB in people living with HIV. The TB cough-in/coffin March began in the Global Village at the XVIII International AIDS Conference in Vienna, Austria at noontime. Scores of people assembled, with t-shirts, placards, cardboard coffins, special Stop TB handkerchiefs, vuvuzelas, drums and banners.

They alternated between coughing into handkerchiefs and chanting the slogans: ‘When you cough, when you sneeze, cover your mouth to stop TB’ or more simply STOP TB! One of the two black coffins bore the messages: "Saved from HIV, but died from tuberculosis".

The marchers wove their way through the ‘Global village’, swelling their ranks with new volunteers as they crossed the conference centre, finally landing in a session room where a lunchtime plenary session on TB/HIV was about to begin. The session, chaired by Michel Kazatchkine, Executive Director of the Global Fund to fight AIDS, TB and Malaria, featured Dr Jorge Sampaio, the UN Secretary General Special Envoy to Stop TB; Marcos Espinal, Executive Secretary of the Stop TB Partnership, Michel Sidibé, Executive Director of UNAIDS and Timur Abdullaev, a human rights lawyer from Uzbekistan who is living with HIV and currently undergoing TB treatment.

August: GDF and its and partners announced a scale up of MDR-TB treatment in India with UNITAID funding. The joint initiative between GDF, the Green Light Committee, The Global Fund against AIDS, Tuberculosis and Malaria and UNITAID represents a new phase of the MDR-TB Scale Up Initiative, which seeks to increase the number of patients receiving second-line drugs and have a positive impact on market dynamics for these drugs, through improvement in price, quality and delivery.

India has the largest TB burden of any country in the world, with one-fifth of all cases. TB is one of the leading causes of mortality in India, and kills nearly 1,000 people each day. India also has more MDR-TB cases than any country in the world.

September: During a crowded week of events organized on the occasion of the United Nations High-level Plenary Meeting on the Millennium Development Goals (MDG Summit), Goodwill Ambassador Craig David made a special announcement at a gala event organized by the UN Foundation and Ray Chambers, the United National Special Envoy for Malaria.

"Tonight, I would like to pledge an exclusive and new recording that I will donate to the fight against tuberculosis," he said. "The song will be available for free download on my own website and on that of the Stop TB Partnership. The goal is to build a powerful online community for raising awareness and fighting the stigma attached to tuberculosis. Tuberculosis sufferers and communities affected need to know that there is no shame in tuberculosis." The song will be released on World TB Day 2011.

October: Following on the launch of the Global Plan to Stop TB 2011-2015 in Johannesburg, the Stop TB Partnership Coordinating Board held its 19th meeting, opened by South African Minister of Health Aaron Motsoaledi. At a landmark session featuring progress, challenges and opportunities relevant to TB Control in Lesotho, South Africa and Lesotho, those countries' health ministers (Dr Mphu Ramatlapeng, Dr Motsoaledi and Mr Benedict Xaba) stressed the need for regional and cross-country harmonization, particularly to promote continuity of care. Noting the high level of TB transmission in many workplaces, especially mines, they called for improved regulation and provision of incentives as well as a new focus on taking up novel technical solutions, such as the new quick TB tests and mobile technology.

November: The Partnership conferred the three awards it announces annually on the occasion of the World Conference on Lung Health of the International Union Against Tuberculosis and Lung Disease, held this year in Berlin, Germany. Dr Armand Van Deun is the recipient of this year's Kochon prize, which is awarded annually to persons, institutions or organizations that have made a highly significant contribution to combating TB. Dr Van Deun is an international leader on improving laboratory testing for TB. His efforts have had an impact on the quality of work performed by laboratory technologists around the world, resulting in untold thousands of lived saved through diagnosis of TB followed by effective treatment.

Also announced were the winners of the Award for Excellence in Reporting on TB and Images to Stop TB Award. The journalism award recognizes outstanding reporting and commentary in print and on the web that materially increases the public's knowledge and understanding of TB and multidrug-resistant TB (MDR-TB), in countries affected by the disease. The Images to Stop Tuberculosis Award seeks to obtain outstanding photos depicting TB prevention and treatment and community activity to raise awareness about it. Both awards are supported by the Lilly MDR-TB Partnership.

On the journalism award, the first prize winner in the low- and middle-income category is Lungi Langa of South Africa. Anna Biernat of Poland takes second prize and Sabina Aliyeva of Azerbaijan third prize. Two journalists tied for the first prize in the high-income category: Andrew Jack of the UK and Canada’s Jen Skerritt. Jenna Sloan and Kate Wighton of the United Kingdom shared the third prize. The winner of the 2010 Images to Stop Tuberculosis Award is the Moldovan/American photographer Misha Friedman. Mr will receive a grant of to produce a photo essay on TB.

December: WHO endorsed a new and novel rapid test for tuberculosis (TB), especially relevant in countries most affected by the disease. The test could revolutionize TB care and control by providing an accurate diagnosis for many patients in about 100 minutes, compared to current tests that can take up to three months to have results. This new 'while you wait' test incorporates modern DNA technology that can be used outside of conventional laboratories. It also benefits from being fully automated and therefore easy and safe to use. WHO is also releasing recommendations and guidance for countries to incorporate this test in their programs. This includes testing protocols (or algorithms) to optimize the use and benefits of the new technology in those persons where it is needed most.

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It has been a privilege and an honour to serve as Executive Secretary ad interim during the second half of 2010. I look forward to serving our Partnership in every way that I can in 2011.

We are proud of our partners' achievements and look forward to a year of ever greater progress. We have a great responsibility to people with TB all over the world. Every step we take should be step towards ending all deaths from TB.

We wish our more than 1200 partners and other friends a joyous holiday season and thank them for their tireless efforts and dedication to stopping TB. We hope you will start the New Year re-energized and ready to continue our common effort to achieve a world free of TB.

Dr Giuliano Gargioni, Executive Secretary a.i., Stop TB Partnership