Eliminating TB in 2030: Accelerating innovation and collaboration to ending TB in South-East Asia side-event at the 73rd session of the UN General Assembly
27 September 2018, New York, USA
Her Excellencies Nila Moeloek and Puan Maharani, minister of health and co-ordinating minister of human development and culture of Indonesia respectively; Shri J P Nadda, minister of health and family welfare, India; Mr Arifin Panigoro; Permanent Representative of Maldives in New York; partners at the Stop TB Partnership, Global Fund, World Economic Forum, CDC, USAID and Johnson & Johnson,
The WHO South-East Asia Region is the most TB-affected Region in the world. It needs maximum attention – the reason we are all gathered here.
Though each of the Region’s countries has a vastly different TB burden, each has a high-level political commitment to seeing their burden ended once and for all.
This is commendable. Importantly, achieving that target requires the adoption of new strategies and technologies.
First, we must switch to active case detection via digital x-ray and genetic testing, at the same time as paying special attention to ensure latent TB is detected and treated. This must happen simultaneously.
And second, we must scale up the coverage of quality services, ensuring they reach at least 80% of the population.
Based on these imperatives we estimate a resource need of USD 2 billion dollars annually. Out of the total funding needs, nearly 50% is for strengthening services. 40% is for accelerating case finding. 10% is for preventive therapy.
The required resources must be found from both domestic and international sources.
As a Region, domestic resource allocations have almost doubled in just one year, from USD 500 million to USD 957 million. India alone trebled its investment.
In conjunction with increased resource allocations, Member States have also embarked on high-level monitoring, and shifted attention towards patient-centred approaches, including the provision of socio-economic support, at the same time as factoring in economic hardships during treatment.
This is a quantum leap of a kind never seen. That said, during the same period, resources from donors and partners remained the same.
Against a resource need of USD 2 billion, last year the funding allocation was less than USD 1 billion, with even less – about USD 0.8 billion – made available.
Out of this, USD 0.5 billion came from domestic sources, and close to USD 0.3 billion came from Global Fund. USAID was the next largest bilateral donor, with an allocation of USD 24 million dollars in the Region per year.
Indeed, we have a long way to go in terms of resource investments and fund-flow mechanisms. But investment must always be commensurate with needs.
In the past, resource needs were mainly based on countries’ National Strategic Plans. Too often these Plans were not as ambitious as they should have been, as they were not based on the full range of needs.
But in 2016 WHO South-East Asia developed and adopted a needs-based costing approach. This approach is fundamental to reaching the End TB target of a 90% reduction in new infections.
While the additional need for countries varies – from around USD 0.6 billion in India and USD 0.2 billion for Indonesia, to about USD 0.4-0.6 million for smaller countries like Bhutan, Maldives and Timor-Leste – the needs are very much present.
Among other interventions, high-burden countries could have access to a TB fund on a replenishment basis if they reach a specific set of criteria.
Indeed, we have an opportunity we cannot let slip.
Let us use this opportunity to harness global commitment and address an issue that is disproportionately local. Let us ensure we have the means to End TB by 2030 at the latest and lift its burden from millions of people across our Region and the world.