Towards ending tuberculosis: what gets measured gets done

The ultimate ambition: end TB

World TB Day 2017 poster: Leave no one behind
World TB Day 2017 poster: Leave no one behind

In May 2014, the World Health Assembly approved WHO’s ambitious new strategy to end the tuberculosis epidemic by 2035. The strategy, with its three indicators and milestones at five-year intervals, had a visionary goal: zero TB deaths, zero TB disease, and zero TB suffering.

Three pillars provided the foundation for this visionary goal: integrated patient-centred TB care and prevention, bold policies and supportive systems, and intensified research and innovation. Though ambitious even for an optimistic organization like WHO, the wisdom of aiming high for TB was being firmly endorsed by external economic evaluations.

In January 2015, The Economist news magazine published a report on “The economics of optimism”, which ranked the benefit per dollar invested in various development initiatives. Reducing tuberculosis ranked first among health development initiatives, showing a return of $43 on every investment dollar. As The Economist noted, the prominence given to TB was a “no-brainer”.

The ranking drew on the work of the Copenhagen Consensus Center, an initiative which commissioned some 60 teams of economists, plus representatives from the UN, civil society, and business communities, to rank the sustainable development targets that would produce the most “phenomenal” value for money. The TB target was one. As the Copenhagen Center noted, “The economic case, put simply, is that TB treatment is low cost and highly effective, and on average may give an individual around 20 years of additional life.”

"The momentum to end TB is already building at the highest political level."

Dr Chan, WHO Director-General

As a further endorsement, the related Nobel laureates guide to the smartest targets for the world 2016–2030, issued in 2015, pared the 169 targets in the 2030 Agenda for Sustainable Development down to just 19. The nine people-related targets included the reduction in tuberculosis deaths by 90%. As the guide noted, concentrating on this select list of 19 targets could triple the benefits for the world’s poorest.

The new End TB Strategy has another solid reason for its hope. In 2016, WHO estimated that, since the start of the century, efforts to stop TB had saved some 49 million lives. To secure high-level commitment to do even more, WHO will be holding its First ministerial conference on ending tuberculosis in the sustainable development era in November 2017 in Moscow, Russian Federation. As requested in a resolution of the UN General Assembly, a high-level meeting on the fight against tuberculosis will be held in 2018. The momentum to end TB is already building at the highest political level.