Asia-Pacific unites in battle against tuberculosis

LISA CORNISH | DEVEX | 1 SEPTEMBER 2015 

Parliamentarians from the United Kingdom and countries in Asia and the Pacific gathered this week in Sydney, Australia, to create a unified voice for the region’s fight against tuberculosis.

“The Asia-Pacific region has more than half the burden of TB globally and almost half the deaths,” Maree Nutt, CEO of Results Australia, which helped coordinate the Asia-Pacific meeting, told Devex. “We need to be addressing TB in our region.”

The Asia-Pacific TB Parliamentary Caucus is the first regional meeting to come out of the Global TB Caucus, which was established in October 2014. In less than 12 months, the global caucus now counts as members 551 parliamentarians from 81 countries — a massive achievement to highlight an often overlooked disease, which kills 1.5 million people annually.

Nick Herbert, a member of the U.K. Parliament who is considered the driving force behind the establishment of the Global TB Caucus, told Devex that the caucus’ progress “has exceeded all of [their] expectations.”

“It’s very important that this initiative, which is unique in terms of a global parliamentary attempt to raise the profile of this disease, generates specific and positive actions by government that we are seeking to influence,” Herbert stressed. “We have a voice — as elected representatives from different parliaments around the world, we hold leaders of our governments to account. Sometimes we put them in office and we very often vote the money that is spent.”

The Asia-Pacific caucus chair, Australian MP Warren Entsch, told Devex he was very excited to see the support the meeting has received from the region.

“We have Indonesia, India, Papua New Guinea, Cambodia, the Philippines, Vietnam, New Zealand and the United Kingdom coming together, and I think that is pretty exciting,” he said, noting that the aim was for the region to provide a united voice on the fight against TB in the next global caucus in November in Cape Town, South Africa.

“The way we are going to fix this is we are going to work together and all have the same goals,” Entsch said. “Part of this thing is to look at how we can increase our regional coordination.”

The meeting saw parliamentarians in attendance commit to five deliverables:

1. To found an Asia-Pacific caucus of parliamentarians open to any political representative from across the region to join, and in doing so, to commit to work collectively and individually to drive progress against TB.

2. To work in national parliaments and regional organizations to build cross-party political support for efforts to eliminate TB by founding national cross-parliamentary groups, which will call for the necessary policies and resources from domestic sources, the Global Fund to Fight AIDS, Tuberculosis and Malaria and other multilateral agencies to more effectively tackle the disease.

3. To support the voices of patients and vulnerable groups in the response to the disease, and in doing so, to take all necessary measures to lift the burden of stigma from TB patients and their families.

4. To support improvements on existing approaches and the development of new approaches to facilitate research and development of new drugs, vaccines and diagnostics, for the prevention, control and treatment of TB, particularly in response to the growing threat posed by drug-resistant strains.

5. To support a regional approach to combating TB in Asia and the Pacific.

No more talk — only action

The message from MPs in attendance was clear: The time for talk is over. It is now time to see real action and ensure TB is prioritized by governments worldwide.

“I confess to an impatience,” Herbert said, stressing his disinclination to return to yearly meetings that only yield insufficient action. “This is a disease the west has beaten once before. We know how to beat this disease and it is a global scandal that this has been allowed to continue.”

And those in attendance agree with Herbert.

“If we continue to wait and its business as usual, there is going to be TB until 2180,” Sarah Kirk, action global health campaign director at Results Australia, told Devex.

A representative from the Philippine Congress, Dr. Helen Tan, meanwhile said that she will be returning to her country with action items to generate greater awareness and action from her government.

“I will be speaking in the plenary when I go back to discuss what I learned from the two days of meeting with parliamentarians here and I will present what we can do as parliamentarian in support of the Department of Health,” she told Devex. “From there, we will continue to progress.”

Stronger focus on R&D, broadening perspective

One other takeaway at the two-day meeting is the need for stronger investment in research and development to fight TB.

“We’ll be looking at ways we can advocate for new treatments for TB,” Entsch said. “Many of the treatments we see today are the same ones that were applied when my mom was in the thoracic ward in Cairns in 1963.”

Kirk said there was agreement that the current method of treating TB will not be the solution going forward.

“Everyone is aware that the current tools we have are almost 100 years old,” she told Devex. “These are not the things we are going to be using to end TB. We have new and exciting drugs coming down the pipeline and they’re going to be spread throughout the world.”

But for caucus attendees, looking at the environment and society in which the disease lives is just as important as medication and treatment.

“The areas we are targeting are impoverished. We’ve got to not just look at giving the medication but looking also at the environment they are living,” Entsch told Devex. “In the Western Province (in southwestern Papua New Guinea), we are capping wells and dealing with sanitation and actually creating a platform to deliver the service. It’s a good model we can use.”

In addition, there will also be a drive to increase support for patients and eradicate social stigma — TB is often referred to as a “disease of poverty” — preventing them from seeking and continuing treatment.

“This is something we have to address together,” Kirk said.

Heightened donor support

“What we hope is that wealthy countries will continue to make a commitment to the Global Fund as the body that is providing forces to fight TB,” Herbert told Devex. “They will increase their commitment to R&D and we also hope they will make commitments in their bilateral programs.”

Nutt said that her country should look further at what role the Australian aid program can play in fighting TB, given its “significantly reducing aid budget.”

“We need to be questioning how we can contribute appropriately to TB control in our region if we don’t have aid resources to do that,” she said.

But Entsch said Australia is already providing strong leadership financially, and has pledged to provide 200 million Australian dollars ($142.2 million) to the Global Fund from 2014 to 2016.

“That’s not an insignificant amount,” Entsch told Devex.

And there is always more that Australia, and other donor countries, could do to provide leadership and support to their region.

“In leadership of course we have a role,” he said. “It’s one of the reasons I have accepted this position and we have quite a number of colleagues that are raising awareness on these issues. I think we are doing quite well and it’s just a matter of continuing to pursue it.”

The importance of NGOs

Nongovernmental organizations will also have to step up their support for delivering outcomes, Kirk said.

“That’s our responsibility,” she stressed. “Today these countries made commitments to our region and the world, now we’re going to be making commitments to support them.”

But NGOs will play a significant role in continuing to educate politicians and the public on TB as well.

“Results [is] very engaged in this process because it has been a political commitment that has been missing for so long,” Nutt told Devex. “It is only with that political commitment that you can bring resources into addressing TB both from an access perspective and improving treatments and diagnostics.”

Nutt cites their work with Herbert to develop awareness as an example of how NGOs working directly with parliamentarians can create change. For Herbert, his visit to Kenya 10 years ago was his first encounter with TB.

“I knew nothing about TB,” Herbert told Devex. “My first question was is there a vaccine. And I was told there wasn’t. I was horrified to see that this disease has claimed so many lives and continues to do so. Yet, in the west, there is a tendency to believe that this is a disease that has been beaten.”

Education and awareness is expected to play an important part of country and regional strategies with many already committing to make TB and issue in parliament and at forums. And it will be critical in ensuring TB is eradicated worldwide by the World Health Organization’s 2035 deadline.