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Ending TB 2020

To end TB, we must prevent TB

Image: The Global Fund / Sarah Hoibak

José Luis Castro

Executive Director, The Union

One of the most alarming aspects of The Union’s work to end the global tuberculosis epidemic, is knowing TB is both the leading infectious killer globally and at the same time a very preventable illness.

Tuberculosis is a terrible illness caused by a bacteria that spreads from person to person through the air. Left untreated the disease typically causes a person to lose tremendous amounts of weight and become increasingly short of breath, withering the body to nothing if left untreated. 

Through their participation in the United Nations, governments committed to ending the TB epidemic by the year 2030. As we enter the year 2020, however, we are far from reaching that goal.

A key part of ending TB is prevention.

We are far from reaching our 2030 goal to end TB

We know from data modeling that ending TB is not realistic without much stronger prevention efforts. We can prevent people from becoming infected with TB, we can prevent people from developing TB disease and we can prevent people dying from TB.

Despite having this knowledge, we are not (with some important exceptions) making nearly enough progress as we need to on TB prevention.

According to the World Health Organization, young children especially are missing out on TB prevention. Every child exposed to TB in their household needs TB preventive therapy before they become sick. Yet only one in four such children receives that therapy. People living with HIV (PLHIV) are also eligible for TB preventive therapy, yet half of PLHIV are going without it.

Against this gloomy backdrop, however, there is hope. There is growing recognition that people at risk of TB have a right to know whether they’re living with a TB infection and to make informed decisions about how to safeguard their own health, including through receiving preventive therapy.

Preventative therapy is becoming more straightforward

And preventive therapy itself is improving, becoming easier for people to take. Whereas standard therapy used to take nine months, today we’re seeing effective preventive options that require taking only one pill weekly for three months, or one pill daily for one month. We’ve also seen a new TB vaccine candidate that could have a significant impact if late-stage testing is successful. 

It is inexcusable that people are dying from this entirely preventable disease. The Union is committed to doing all that we can to help countries prevent TB. The rationale is simple: to end TB, we must prevent TB.

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