24 March 2015 - Johannesburg, South Africa - This World TB Day, I write to you from South Africa, as part of the event to launch an unprecedented national effort and campaign - impressive because of its vision, boldness, country ownership and courage. I am here with the Deputy President Cyril Ramaphosa, Minister of Health Dr Aaron Motsoaledi (Chair of the Stop TB Partnership Board) and numerous other guests as the country launches its biggest campaign ever under the overall umbrella of ‘Ending South Africa’s TB epidemic: Accelerating our response in key populations’ to win the fight against TB. The country's national strategic plan is hugely ambitious with a call for all South Africans to be screened for TB at least once a year. This is a bold step in the direction of moving from just 'saving the dying' to a state of 'keeping the population healthy and devoid of TB'.
It takes courage as a Minister of Health to convince your government, your teams and staff, the local communities, the private sector and partners, that if you are serious about stopping TB, you must focus on the vulnerable groups. It takes courage to take that extra step and put in place a big national campaign. It takes the courage of all health workers, the doctors and nurses to make it all happen. It takes courage to set ambitious targets for reaching and testing vulnerable groups, when too many in this world are trying to ignore these groups exist. It takes courage and vision to understand that without addressing the TB situation in miners and their families, prisoners, and children -- no real progress can be made.
This five year campaign aims to ensure that at least 90% of vulnerable and at risk populations are screened for TB, at least 90% of all TB cases in the country are diagnosed and started on treatment, and to achieve at least 90% treatment success. This equates to at least 90% of 150,000 inmates being screened (135,000), at least 90% of 510,097 miners being screened (459,088), and at least 90% of 5.1 million community members being screened (4.5 million).
The revolutionary idea behind South Africa’s campaign is that Health Minister Motsoaledi has made it unacceptable for his citizens to continue to live with this disease, and he wants to free his population from TB. And save lives. We know and hope that more and more countries and ministers will go down the same path and will have the courage to focus their efforts and interventions towards the ambitious targets of the Global Plan to Stop TB 2016 - 2020 on the road to Ending TB.
This is why I wanted to make this World TB Day statement about courage. The courage of saving lives. The courage of continuing our work even when we feel it is not rewarding enough, the courage of pushing boundaries and taking risks, the courage to change and promote innovations, the courage of thinking out of the box. The courage of looking at our work and accepting the achievements as well as the failures, the courage of leaving aside personal agendas, our own ambitions, fears and understanding the consequences of inaction.
The courage to look and speak and share and scream about what TB really means. The courage to understand the stark reality of the numbers launched today in London by UK Prime Minister David Cameron’s Panel on Antimicrobial Resistance: Over the next 35 years, 75 million people could lose their lives to drug-resistant TB, and by 2050, the airborne infection could cost the global economy almost US$ 17 trillion.
These are staggering estimates by any measure - they reveal the enormous costs of global inaction on drug-resistant TB. We therefore need a collective courage and this can start with all those that understand the threat posed by Antimicrobial Resistance. Global stakeholders such as the G7 can show vision by starting to address drug-resistant TB in an aggressive manner in order to ensure that the nightmare scenario presented by the UK panel today is averted.
It takes courage to invest in programmes with TB accounting for more than half the estimated 8.7 million lives saved by the Global Fund ever since its launch in 2002. In 2013, 11.2 million people were treated for TB. It takes courage to work on research and development for TB - funding is challenging and mycobacterium tuberculosis is difficult to find and kill. It takes courage to keep going and to put all your efforts to develop new drugs, new compounds, new regimens, new vaccines and new diagnostics. It takes courage to be from a community, an activist or advocacy group, affected by TB or HIV, to stand up and fight for your rights, your voice, your engagement.
It takes courage to fight the diseases, to get diagnosed and to follow the very difficult treatment. It takes courage to ignore and fight the adverse effects of drugs, unfriendly systems, fears, pre-conceptions, stigma.
It takes courage to fight TB. And from the small mining city of Orkney where I met fantastic health and community workers committed to treating every child and every family from the mining community, to wherever this message finds you on World TB Day, let’s think of the courage we all have and show in the fight with this disease. And commit to even more until we END TB!
Dr Lucica Ditiu
Stop TB Partnership