Stop TB Partnership Launches New Global Plan, World’s Largest Funding Call For TB Grassroots Organizations, & Pediatric DR-TB Initiative

A new plan to dramatically accelerate global efforts to end tuberculosis, one of the world’s deadliest and oldest known infectious diseases, was launched Tuesday by the Stop TB Partnership in Jakarta.

The fully-costed plan is based on commitments made at a 2018 United Nations High-Level Meeting on Ending TB (UNHLM) to reduce TB deaths by 1.5 million people by 2022.  Two other initiatives – one to mobilize civil society support and another to launch a new regimen for treating drug-resistant TB in Indonesian children – were launched in tandem to increase efforts towards.

“I feel we are finally starting to get what we need to end TB. There is a long way to go; but we see light at the end of the tunnel,” said Stop TB Partnership’s Executive Director, Lucica Ditiu, in a press release.

According to the roadmap, funding for TB prevention, care, and R&D must be rapidly scaled up in order to reach global targets for reducing TB in line with 2022. Currently, funding for TB treatment and prevention stands at less than US $7 billion per annu; that must be doubled to at least US $14 billion per annum. R&D funding must be nearly tripled to over US $2.16 billion per annum.

“It is not just about launching the Global Plan, it is also about launching concrete tools and funding to implement it,” said Ditiu. “We have the largest-ever call for proposal from grassroot organizations as we must ensure that civil society and communities remain our full partners in ending TB. And we share with the world the pediatric formulations for children with drug resistant TB.”

Political leaders, Ministers of Health, TB survivors, donors, and TB experts from around the world gathered Tuesday for the official launch of the “Global Plan to End TB 2018 – 2022: The Paradigm Shift” in Indonesia, a country with one of the highest TB burdens in the world.

Globally, it is estimated that 10 million people developed TB disease in 2018, and around 3 million people who developed the disease were unable to get proper treatment for it.

In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis.

The new plan is an update and extension of the “Global Plan to End TB 2016-2020,” and follows on from last year’s first ever UNHLM on tuberculosis. While some heads of state from the G7 countries – the biggest donors to global health aid – and some high-burden TB countries were noticeably absent from the High Level Meeting, the event still  set a new tone for TB advocacy, and led to 129 countries signing onto the first ever Political Declaration on TB during the 73rd UN General Assembly – which outlines goals that are embedded in the Stop TB Partnership’s roadmap and budget.

If the plan is fully implemented by 2022, the Stop TB Partnership estimates that 40 million people will be treated for TB, including 3.5 million children and 1.5 million people with drug-resistant TB, and over 30 million people will receive TB preventive therapy. This will lead to 1.5 million fewer deaths due to TB and there will be a US $44 return on investment for every US $1 spent.

While the plan encourages upper-middle- and high-income countries to scale up domestic funding, it also notes that donors will need to step up external commitments to help support low- and lower-middle income countries. With the Global Fund to Fight AIDS, TB, and Malaria’s recent successful US $14.2 billion replenishment in October, the fight to end TB received a US$840 million annual boost for the next three years.

However, the Stop TB Partnership says that external funding will still need to be scaled up to fill the remaining funding shortfall of US $5.1 billion per year, warning that a five-year delay in increasing funding for TB R&D could lead to 13.8 million more people developing the disease and 2 million more people dying by TB.

Launch of a Multimillion Funding Facility for Civil Society 

Along with the updated global plan, the Stop TB Partnership is launching the “Challenge Facility for Civil Society 2019” – a fund of US $2.5 million in grants for civil society and community-based organizations (CBOs) who provide crucial advocacy and support to some of the hardest to reach populations impacted by TB.

According to the Stop TB Partnership, certain vulnerable populations face both an increased risk of contracting active TB and facing stigma due to where they live or work, leading to limited access to quality TB care. A number of community-based organizations and small non-governmental organizations have sprung up around the issue to help provide support to these affected communities.

The new funding facility will hold the largest-ever call for proposals for TB-affected community and civil society grassroots organizations. It will be supported by funding from USAID and the Global Fund, and the 12-months grants will range from US $25,000 to US $150,000.

Organizations from 14 high-burden countries – Bangladesh, Cambodia, DR Congo, India, Indonesia, Kenya, Mozambique, Myanmar, Nigeria, Pakistan, Philippines, South Africa, Tanzania, and Ukraine – are eligible to apply for funding. Organizations that operate regionally in anglophone Africa, francophone Africa, Asia, Latin America, the Caribbean, or Europe are also invited to apply.

Fighting Drug Resistant TB in Children – A New Initiative 

Tuesday also marked the official launch of the Stop TB Global Drug Facility’s Pediatric Drug-Resistant TB (DR-TB) initiative, launching child-friendly formulation of medicines used to treat drug-resistant TB (DR-TB) in Indonesia.

Of the estimated 1.1 million children under the age of 15 who became sick with TB around the world in 2018, an estimated 32,000 had MDR-TB. Of those, fewer than 5% are diagnosed and receive treatment. It’s estimated only 500 children under the age of five received treatment for DR-TB in 2018.

The Pediatric DR-TB Initiative will make child-friendly formulations of TB drugs like cycloserine (above) available to children who need them.

The dissolvable, flavored formulations of essential DR-TB drugs are already used in 56 other countries, including high-burden countries Nigeria and Haiti, and will replace the crushed-up tablets and intravenous injections currently used to treat drug-resistant TB in Indonesian children. The new treatment regimens for children are also shorter, and cause less dangerous side effects than traditional treatments for drug-resistant TB.

“What you often don’t see when looking at the crushing problems posed by TB—either at home or around the world—is how the disease affects children,” said Nigeria’s Minister of State for Health and Stop TB Partnership Board Member Osagie Emmanuel Ehanire.

“No child should have to suffer from DR-TB and we are committed to reaching these young children and treating them with these new medicines.”

The Stop TB Partnership’s Global Drug Facility (GDF) piloted the pediatric drug procurement initiative last year, with help from the Sentinel Project, in early adopter countries in order to pool demand from eligible countries and facilitate access to the child-friendly medicines. Through the pooled-demand mechanism, the GDF has negotiated price reductions of up to 85% for certain medicines in the child-friendly regimen, and has facilitated the procurement of the treatments in 16 countries in 2018 and an additional 40 countries in 2019.

So far, 1,100 treatments for children with drug-resistant TB have been procured, with the goal to reach the UNHLM target of treating 115,000 children with drug-resistant TB by the year 2022.

Image Credits: Stop TB Partnership, Maggie Steber/Stop TB's Global Drug Facility.

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