'It always starts with a dream' - World TB day 2022

What do St Therese of Lisieux, St Bernadette, Jane Austen, Eleanor Roosevelt, Emily Bronte, DH Lawrence, Louis Braille and Cardinal Richelieu have in common? The answer is that they all died of tuberculosis, (TB).

TB is sometimes called, 'the forgotten disease' and people are often under the misapprehension that it has been eliminated for hasn't the BCG vaccine we were given as children got rid of it?" they sometimes say. Yes, the BCG vaccine does exist to combat TB, but it was developed over 100 years ago and does not protect most people against the most infectious or deadly forms of TB. TB can be diagnosed, treated and prevented. However, treatment regimens are long and complex and many strains of TB have become drug-resistant or multi-drug resistant, meaning normal methods of treatment don't work. TB has learnt how to overcome medication by mutating.

A dangerous combination of complex treatment methods, lack of an effective vaccine and a historic and chronic lack of political will and investment means that, despite how long it has been in existence, TB remains one of the deadliest infectious diseases - second only to COVID-19 - TB killed more people in 2020 than HIV and malaria combined and it still kills more than 41,000 people each day.

The sad fact is that Tuberculosis is a disease which has survived for 70,000 years and still affects over 10 million people each year. It is a contagious bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person. TB commonly attacks the lungs but can affect any part of the body, from the bloodstream to the brain. Despite being a preventable, detectable and curable disease, in 2020, 1.5 million people died from TB and there were 10 million new cases diagnosed, as well as many more cases which remain undetected.

TB is a disease of poverty with 95% of cases and deaths in low- and middle-income countries

2020 saw the number of people who died from TB rising for the first time in a decade and a drop in the number of people diagnosed with TB - likely meaning an increase in the number of TB cases going undetected and untreated.

Each year, we recognize World TB Day on March 24. This annual event commemorates the date in 1882 when 140 years ago Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB). For the first time in over a decade, TB deaths increased in 2020. The theme of World TB Day 2022 - 'Invest to End TB. Save Lives. ' conveys the urgent need to invest resources to ramp up the fight against TB and achieve the commitments to end TB made by global leaders.

The Global Fund is an international financing institution, designed to accelerate the end of AIDS, tuberculosis and malaria epidemics. AIDS, TB and malaria are all preventable and treatable and the partnership aims to promote innovative solutions to these global health challenges and future ones.

Since its inception in 2002, the Global Fund has grown into one of the largest and most effective multilateral health organisations in the world. During the past twenty years the Global Fund has saved more that 44 million lives. The Global Fund has invested in programmes to strengthen healthcare systems across more than 155 countries and provided prevention, treatment and care services to hundreds of million people, resulting in the number of deaths caused by AIDS, TB and malaria each year have been reduced by 46% since 2002 in countries where the Global Fund invests.

The Global Fund's COVID-19 Response Mechanism (C19RM) is now the primary channel for providing grant support to low-and middle-income countries for COVID-19 tests, treatment, and PPE. In more than 120 countries around the world, the Global Fund continues to make urgent adaptations to life saving HIV, TB and malaria programmes to respond to COVID-19 cases in endemic countries.

In September 2021 Pope Francis addressed the participants of the plenary assembly of the Pontifical academy for life. The theme of the 3-day meeting was of 'public health in the horizon of globalization.' Pope Francis spoke of the importance of a synergy between disciplines for 'Knowledge of biology and hygiene is needed, as well as of medicine and epidemiology, but also of economy and sociology, anthropology and ecology.' He said.

For, he continued, 'Many very serious problems are ignored due to lack of an adequate commitment. Let us think of the devastating impact of certain diseases such as malaria and tuberculosis: the precariousness of health and hygiene conditions cause millions of avoidable deaths in the world every year. If we compare this reality with the concern caused by the Covid-19 pandemic, we can see how the perception of the seriousness of the problem and the corresponding mobilization of energies and resources are very different.'

Pope Francis' comments are borne out by the figures for vaccine development against the two diseases, TB and Covid-19 are the two top infectious disease killers in the world today but there is a deadly divide in play in the money available for vaccine development.

Money given for vaccine development:

Covid-19 US dollars 100 billion

TB US dollars 117 million

The idea for the Global Fund arose from a wellspring of grassroots political advocacy coming face-to-face with the imperatives of global leadership. Kofi Annan who was then the Secretary General of the United Nations said, "When I first mooted the idea of the Global Fund, people said I was dreaming... I love dreams. It always starts with a dream."

The Global Fund Replenishments provide opportunities for countries to make financial pledges to the Global Fund, for three-year cycles, so it can function effectively. The 7th Global Fund replenishment is due to take place in September 2022. Replenishments are key moments for advocates to speak to governments about the Global Fund and push for political will to end AIDS, TB and Malaria.

As Pope Francis points out the world needs to wake up to the seriousness of the millions of avoidable deaths in the world. As we have seen with Covid-19, 'Disease anywhere is disease everywhere'. On this 140th World TB Day would that we were all able to dream dreams of the end of TB and do what we can to make that dream a reality.

For more information see:

www.results.org.uk/news/take-action-fight-end-tb

www.results.org.uk/blog/world-was-very-different-place-100-years-ago

Address by Pope Francis www.vatican.va/content/francesco/en/speeches/2021/september/documents/20210927-assemblea-pav.html

Every day more than 41,000 people die from TB, an airborne and preventable disease.

* The only project in London caring for homeless people in London with TB, is Olallo House, run by the Brothers of the Saint John of God Hospitaller. They are marking their 10th anniversary this year. For more information see: http://sjog-olallo.uk/olallo-house.php

See report on ICN tomorrow. To support their work see: www.justgiving.com/campaign/SJOGOlallo