The G20 1st Health Working Group Side Event on tuberculosis (TB) that took place in hybrid form on 29 and 30 March 2022, called on the group’s member states to improve current approaches, and explore new approaches to investing in theTB response. The two-day event, hosted by the Indonesian G20 Presidency and Stop TB Partnership Indonesia with support from USAID and the Stop TB Partnership Secretariat, will contribute inputs to the final G20 communique.
At the event, titled ‘Financing for TB Response: Overcoming Covid-19 Disruption and Building Future Pandemic Preparedness,’ high-level country representations, heads of leading international organizations, donors, and global health and financial experts discussed the best ways to finance the TB response. Participants recommended a multicomponent approach, using multilateral, bilateral, and domestic mechanisms to mobilize additional resources for the TB response and prepare the world for future airborne pandemics.
“The world's current investment in TB response and research still leaves close to 40% of people with TB missed by the healthcare system and left untreated. As much as we need to remain focused on serving people with TB, families, and communities, we must invest smarter to end this infectious disease killer and end it by 2030,” said Budi Gunadi Sadikin, Minister of Health of Indonesia.
The 2022 G20 Presidency of Indonesia has demonstrated strong leadership in shining a spotlight on the need to refocus efforts to end TB globally through increased commitments to not only sustain existing finance flows, but also adopt newer financing methodologies at global, national, subnational, and community levels.^
India, set to assume the G20 presidency in 2023, was represented by Dr. Mansukh Madaviya, Minister of Health and Family Welfare and Chair of the Stop TB Partnership Board. Thanking the G20 presidency of Indonesia, he spoke at length about harnessing the TB response to address COVID-19 disruptions and future pandemics. He urged G20 member states to focus on international collaborations, public-private partnerships, and knowledge exchange.
“Technological innovations and forward-looking strategies implemented in the combat against COVID-19, such as rapid development of vaccines, investment in infrastructure like critical care units and molecular diagnosis, coupled with strong political leadership, can be used as an effective template to strengthen TB mitigation measures further and help us in developing a rapid response to any future pandemics,” said Minister Madaviya.
TB is the world's second-deadliest infectious disease, with 4,100 people, including 700 children, dying of this preventable and curable disease every day. The COVID-19 pandemic and related recovery measures have led to an increase in TB deaths in 2020, reaching 1.5 million people, and reversed years of global progress in tackling this disease.
"TB was here before COVID-19 for hundreds of years and it will continue to kill more people than any other infectious disease after COVID-19 is no longer an emergency. It is a shame on humanity that we have not been able to end this airborne disease,” said Dr. Lucica Ditiu, Executive Director, Stop TB Partnership. “If COVID-19 taught us something, it is that what we’ve been asking for years. Once there is fear and global solidarity to end a disease, funding is not a problem; the solidarity of researchers to find new tools is not a problem; mobilization is not a problem. We demand nothing less for TB!” she added.
The TB response has been suffering from years of funding shortfalls, with less than 40% of the funding needed available every year. Yet, experts agree that reaching the joint goal of ending TB is feasible if countries step up their funding commitments. Countries of the G20, for example, who represent 50% of the global TB burden, had a collective GDP of US$66 trillion in 2020, which is projected at US$99 trillion in 2026. The Stop TB Partnership estimates that mobilizing only 0.01% of this collective GDP would make an additional US$6 billion available per year for the fight against TB now and US$10 billion per year by 2026.
While elaborating on the lessons learned from COVID-19, Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, highlighted the need for a resilient, sustainable, and funded response to end TB. He said, “Investments in TB will yield significant benefits through lives saved, healthcare costs subverted, and increased productivity. It's not a question of whether we can afford to invest in TB. It's a question of whether we can afford not to. We urge the G20 countries to invest in tools old and new that save lives, protect health, and enable individuals, families, communities, and nations to thrive.”
To end the TB epidemic, the world needs at least US$13 billion in 2022 and US$19.6 billion per year from 2023-2030 for TB prevention, treatment and care, according to the Stop TB Partnership’s latest projections. With only US$5.3 billion invested by countries in 2020, global investments will need to increase fourfold. An additional US$4 billion per year will be required at the international level for research and development (R&D) of the new diagnostics, medicines, and vaccines needed to end TB. This means quadrupling investments from the currently available US$0.9 billion per year.
Achieving these goals requires that additional investments are secured for the TB response and TB research by governments, donors, and the private sector, including through a successful Seventh Replenishment of the Global Fund to Ends AIDS, Tuberculosis and Malaria (Global Fund) in 2022 and through traditional and innovative financing mechanisms.
“We are seeking to raise US$18 billion through the 7th replenishment, which will be hosted by US President Joe Biden. A successful 7th replenishment is critical to ensuring together, we can accelerate progress against TB. If we successfully raise this amount, we will be able to increase our funding for TB to around US$1 billion (i.e., US$3 billion of the US$18 billion raised will be specifically devoted to TB). While the bulk will have to come from domestic funding, it is critical to have external funding support,” said Peter Sands, Executive Director, The Global Fund.
The year 2022 is critical for the global fight to end TB, and the ultimate goal of ending TB in 2030, as the world faces a fast-running countdown to reaching the 2018 United Nations High-Level Meeting (UNHLM) TB targets, which the international community agreed to meet by the end of December. All projections show that the world is not on course to meet the UNHLM treatment targets set for 2022.
“We need to ensure that while we invest in strengthening overall health systems, we are also investing directly in TB, and that needs to be done with the most effective evidence-based tools available. It won’t be possible to carry on being like this without innovative financing and other resources to address the significant funding gaps within high TB burden countries,” said Atul Gawande, USAID Assistant Administrator for Global Health.
Concluding the event, the Indonesian G20 Presidency proposed a timeline to consult with G20 members, invited countries, international organizations and the Health Working Group representatives to discuss the 'Call to Action on Financing for TB response.'
Next steps
In the first week of April, the Indonesian G20 Presidency will share with participants the meeting summary and the 'Call to Action.' The Indonesian G20 Presidency will disseminate the final draft 'Call to Action' to get any further inputs by early June 2022.
It is expected that the 'Call to Action' will be adopted as part of the declaration of the G20 Health Ministers meeting to be held later this year.
Watch the Sessions below.
Day 1
Day 2