2020 is a pivotal year for the fight to end tuberculosis (TB). Millions of lives depend on the success of our collective efforts to accelerate the TB response to reach the 2022 targets committed by Heads of State in the political Declaration of the 2018 UN high-level meeting on TB. This year’s World TB Day theme, “It’s time”, emphasizes the urgency for action by stakeholders across all levels and sectors of government, partners, civil society, communities, and affected individuals and their families, to end the needless suffering and death caused by TB.
Tuberculosis remains the world’s deadliest infectious killer. Each day, over 4,000 people lose their lives to TB and close to 30,000 people fall ill with this preventable and curable disease. Drug-resistant TB poses a dangerous public health threat. Viet Nam is among the 30 countries with the highest burden of TB. WHO estimated that 174,000 people developed TB in Viet Nam in 2018; there were 11,000 deaths.
Urgent action is needed, and Viet Nam must rise to the challenge to protect the health of its people and ensure universal access to care.
As a nation, what are the key steps we can take in 2020 to turn the tide on this epidemic?
First, we need to recognize that the fight against TB cannot be won by the health sector alone. Ending TB requires concerted action by all sectors of our society to provide the right services, support and a safe environment in the right place, at the right time. Everyone has a role to play in ending TB – individuals, communities, businesses, governments, societies, and everyone must be accountable.
Second, everyone with TB should have access to rapid molecular tests, treatment - including fully-oral treatments for people with drug resistant TB, and care. This is a matter of social justice, fundamental to WHO’s goal of universal health coverage. To urgently improve access to care and close gaps, WHO Director-General Dr Tedros Adhanom Ghebreyesus launched a flagship initiative - Find. Treat. All. #EndTB that is being implemented jointly with the Stop TB Partnership and the Global Fund. Other initiatives led by the US Agency for International Development (USAID) and the Strategic Initiative of the Global Fund are also contributing to this effort.
Third, we need to urgently tackle the MDR-TB public health crisis. Only 1 in 3 of the people who need MDR-TB treatment have access to it. This has a devastating impact on MDR-TB patients and their families, as well as the community. To address this, WHO has issued new guidelines on MDR-TB treatment as well as recent rapid advice which will result in better treatment outcomes for MDR-TB patients and save lives. We are already working with the National TB Program to roll out these changes in Viet Nam.
Fourth, we need to ramp up access to TB preventive treatment, that can stop TB infection from turning into active disease. About a quarter of the world’s population are estimated to have TB infection. While access to TB preventive treatment has increased in the past few years, coverage is still low. WHO has strongly recommended treatment for TB infection in two priority groups: people living in the household of or in close contact with a TB patient including children under 5 years, and people living with HIV. Today, shorter and safer preventive treatment options – more affordable than ever - are available to us. We need to take advantage of these opportunities to protect people from TB.
Fifth, we need to implement policies for the poor and marginalised that don’t encourage stigma or discriminate. This will ensure that our citizens feel comfortable accessing care in a timely manner.
Sixth, there needs to be an intensification of TB research and development. We need new diagnostics, drugs and vaccines to emerge from the research pipeline if we want to end TB by 2030. Role of research for TB is very important in progress of ending TB and Viet Nam established a centre for research of TB (VICTORY)
Last, but most important, we need to ensure adequate domestic and international investments to end TB. Every USD 1 invested to end TB, returns USD 43 plus the multiple benefits of a healthy functioning society. Ending TB is not only a moral imperative, it makes economic sense. Viet Nam has established a national TB programme providing TB services to the people. The country also established a national TB commission to mobilize resources and coordinate the support of multiple sectors in ending TB.
In 2019, Viet Nam developed the national action plan to end TB by 2030. In order to achieve the objectives of this plan, besides strengthening current interventions, Viet Nam must harness new technologies and innovation. For example, double X (chest x-ray and GeneXpert) is a very important innovation to increase detection of TB.
World TB Day this year, is a crossroads for the fight to end TB – we need to unite forces to take the path of success that will save lives and end suffering. Our vision is that no one with TB will miss out on the care they need. WHO will stand by every country, partner, society or person that decides TB has no place in its future.
The clock is ticking. We cannot lose another second. There has never been a better opportunity to make TB history.
It is time to deliver on our promises.
It’s time to END TB!