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Partners,
I am very pleased to take part in this First Stop
TB Partners’ Forum. Key partners from governments, donors,
multi-lateral and bi-lateral agencies, scientists, health and
community workers and ordinary people join me in giving their full
support to the Global Plan to Stop TB. And today, WHO is honoured to
play a lead role in the fight against TB.
In 1998, I launched the Stop TB Initiative at the
Global Conference on Lung Health and made a call for partners to join
this important initiative. I am grateful that our call to partnership
was heard. I am especially proud of today’s results: over 120
organizations working together against TB; shared values and
principles; a clear vision; a mission; and a comprehensive plan for TB
control - The Global Plan to Stop TB.
The Stop TB Partnership has broken the mould with
its innovative approach to development. And we have learned more about
what it takes to make these partnerships work: transparency,
imagination, trust - and, above all, shared responsibility for jointly
agreed goals.
Partnerships and collaborations are the future of
global health. Other worldwide initiatives such as the Global Alliance
for Vaccines and Immunization (GAVI) and Roll Back Malaria serve as
dynamic examples of partnership commitments turned into action. Action
that will soon turn into results that have the potential to change
people’s lives, particularly for the poor - those living on less
than US$ 2 a day. They are the ones who suffer disproportionately from
the ravages of communicable diseases.
In 1998, communicable diseases were responsible for
about 34% of the total burden of diseases worldwide, but nearly twice
that - 64% - among the fifth of the global population living in
countries with the lowest per capita income. It is a scandal that 13
million people die each year from diseases we have the means to treat
or prevent.
Our work has clear targets. The UN Millennium
Summit committed to halve the mortality from TB and malaria and reduce
new HIV infections by 25% within ten years.
TB, thought by many in the industrialized world to
be a scourge of the past, remained, for years, the leading single
infectious cause of adult death. Again, we have the tools necessary to
find and cure almost every single case of TB.
The numbers are all too familiar.
Last year, AIDS caused about 2.7 million deaths, as
it has overtaken TB a couple of years ago; TB killed an estimated 1.7
million; over a million people perished from malaria.
In recent years, the growing emergencies, like TB
and HIV and multi-drug resistant TB have managed to wreak havoc not
only on human lives and public health systems but on the economy of
many countries.
The Commission on Macroeconomics and Health will
publish its report at the end of this year. It will explain how
communicable diseases - particularly HIV/AIDS, TB and malaria - are
major causes of poverty. It will show that the full economic cost of
disease within poor communities have been under-estimated.
We already know that HIV prevalence rates of 10-15%
- which are no longer uncommon - can translate into a reduction in
growth rate of GDP per capital of up to 1% per year. TB is estimated
to take an annual economic toll equivalent to US$ 12 billion dollars
from the incomes of poor communities.
What would Africa’s GDP be now if malaria had
been tackled 30 years ago, when effective control measures first
became available? Probably about US$ 100 billion greater than it is
now.
The success or failure of our collective response
to these threats is critical. It holds the key to the economic and
physical security - not just of individuals and communities - but of
nations and continents.
Improving health is a concrete measurable way of
reducing poverty and inequity - both at country and global level.
Investments in health are investments in human potential. And human
potential is the greatest resource for development.
We need to do this by ensuring that people know
about proven, effective interventions. They must also be able to
access and benefit. Effective treatment for those with TB, insecticide
treated mosquito nets to reduce malaria mortality, and access to
treatment and care for those who are living with HIV/AIDS.
In working towards its shared vision of a world
free of TB, Stop TB actively promotes global health equity. A vision
which has poor people and communities as well as marginalized people
at its centre.
The TB Partners have come together and developed the
Global Plan to Stop TB. The Plan describes the strategies,
priorities and the resources needed over the next five years.
Investing in the Plan makes sense. While the Plan
does say that it will be a long time before TB is eliminated as a
public health problem, it also confidently states that we, the global
partnership, have the mechanisms in place to control the disease.
The overriding purpose is to communicate one simple
message: We can control TB.
The Global Plan to Stop TB has four very clearly
defined objectives:
- EXPAND
our current strategy, DOTS, so that all people with
TB have access to effective diagnosis and treatment.
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ADAPT this strategy to meet the
emerging challenges of HIV and drug resistance.
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IMPROVE existing tools by developing
new diagnostics, new drugs and new vaccine.
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STRENGTHEN the Stop TB Partnership so
that proven TB control strategies are effectively applied.
These objectives provide direction for Stop TB
Partners. Most importantly, the Plan ensures a monitoring mechanism,
allowing partners and donors in TB control to assess progress and
re-direct efforts as needed.
In combating disease, we rely on well-functioning
health systems. Strategic interventions like DOTS provide us with an
opportunity to strengthen health systems and contribute to sustainable
development. DOTS provides cost-effective actions to improve health,
is done in the community, and makes care available in ways that are
inclusive and fair.
DOTS strengthens primary health care as it relies
on secure routine delivery of health services through clinical
facilities, health promotion activities, laboratory networks,
community volunteers, drug and reagent supplies and good management
and administrative support.
The Global Plan to Stop TB estimates the five-year
cost of TB control to be US$ 9.3 billion with a funding gap of about
US$ 4.5 billion. It is crucial that we can come up with these
resources. The 22 most-affected countries will provide their
share, but it is clear that a major injection of development aid is
needed to achieve our goals. With TB on the increase also in
industrialized countries, this is not only the right thing to do - it
is also an act of enlightened self-interest.
Like all plans, this Plan is only as good as the
action it produces. It is, therefore, flexible and adaptable. It will
have to revisited and updated in a rapidly changing environment.
Governments and local communities have
responsibility for planning and implementing their control programmes.
If it is to be successful, TB control cannot be imposed from outside.
The fact that nearly all the 22 most-affected countries have developed
national plans to control TB is therefore encouraging.
I would also like to comment on WHO’s commitments
and contributions to the global movement against TB. First, WHO hosts
the Stop TB Secretariat and the Global TB Drug Facility, which is
providing cheap supplies of first-line drugs to a number of countries.
We are also proud to play a leading role in the important working
groups of the Stop TB Initiative.
WHO has taken a lead in providing a framework for
the Stop TB partnership and has fostered collaborative approaches to
battling HIV/AIDS and TB. This has been echoed by the
UN Secretary-General’s appeal and by the sponsorship and
catalytic action of groups like the Open Society Institute.
WHO is supporting countries technically through
joint action in HIV/AIDS and TB teams in the organization at all
levels.
The need for improved global health is,
indeed, a partnership responsibility. It is the responsibility
of partners, leaders, representing the private, public and
voluntary sectors, like all of us gathered here today.
Ladies and Gentlemen,
Better health provides people with an opportunity -
both as a good in its own right, and as a means that can enable many
of the world’s poorest to emerge from poverty. We have an
unprecedented opportunity to make a difference. And we, as a global
partnership, can do just that.
Thank you.
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