The World Health Organization (WHO) and the Global Fund to Fight AIDS, Tuberculosis and Malaria highlighted a funding gap of at least $1.6 billion a year in international funding for treatment and prevention of tuberculosis (TB).
Speaking to the media in Geneva, Dr Margaret Chan, Director General of the WHO, and Dr Mark Dybul, Executive Director of the Global Fund, said that the only way to carry out the urgent work of identifying all new cases of TB, while making progress in providing successful treatment for all patients suffering from the disease, will be to mobilise significant new funding from international donors.
The overwhelming majority of international funding for TB is currently coming through the Global Fund. The two health executives said that it is imperative that the Global Fund’s fund raising drive this year is successful. The Global Fund raises new funding every three years to finance grants worldwide against the three diseases. This year, the Global Fund is raising funding for 2014 – 2016. Alarm about the growing threat of strains of the disease that do not respond to the standard antibiotic treatment (multi-drug resistant TB or MDR-TB) is making the need for sufficient funding even more pressing.
“We are treading water at a time when we desperately need to scale up our response to MDR-TB,” said Chan. “We have gained a lot of ground in TB control through international collaboration, but it can easily be lost if we do not act now.”
Filling the $1.6 billion gap—of which nearly 60 per cent is for support to WHO’s Africa region—could enable full treatment for 17 million TB and multidrug-resistant TB patients and save six million lives between 2014-2016.
The new estimates follow a series of consultations carried out by WHO, the Global Fund and the Stop TB Partnership to help selected high TB burden countries review their priorities for the next three years and estimate available funding and gaps.
“It’s a shame that in the year 2013, people are still dying from TB,” said Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership. “It’s time to stop this disease now, but as these figures today show, this can’t be done unless there is a significant change in the amount of international financing made available to complement countries’ own funds. Because the vast majority of TB programmes are heavily dependent on the Global Fund, we must ensure that the Fund is fully replenished if we are going to achieve our ambitions.”
Despite significant progress over the past decade, the number of people who fall ill with TB is declining at just two per cent a year globally. Many countries in Africa and Europe are not on track to achieve the global target of halving the TB death rate between 1990 and 2015. In 2011, 1.4 million people died due to TB, with the greatest per capita death rate in Africa. MDR-TB presents a major threat, with an estimated 630,000 people ill worldwide with this form of TB today.
In the 118 countries included in the estimates, there are four priority areas for domestic and international investment to drive down deaths, alleviate suffering, cut transmission and contain spread of drug resistance:
- For the core areas of expanded diagnosis and effective treatment for drug-susceptible TB (which will prevent MDR-TB), a total of $2.6 billion is needed each year for the 2014-2016 period. For 2011, funding of about $2 billion was available. In low-income countries, especially in Africa, this is the largest area for increased financing.
- Prompt and effective treatment for multidrug-resistant TB requires an estimated total of $1.3 billion per year. This is where the greatest increase in funding is needed in the coming years. For 2011, funding of $0.5 billion was available.
- Uptake of new rapid diagnostics and associated laboratory strengthening, especially for the diagnosis of MDR-TB and for TB diagnosis among people living with HIV, requires $600 million per year.
- Excluding anti-retroviral treatment for TB patients living with HIV, which is financed by HIV programmes and their donors, about $330 million is required for HIV-associated TB interventions, such as testing TB patients for HIV, ensuring regular screening for active TB disease among people living with HIV, and providing TB preventive treatment.
Traditionally, domestic funding pays for most of the world’s national TB programmes. The additional $1.6 billion needed each year through international financing supplements this domestic funding, in particular in low-income countries.
EP News Bureau – Mumbai