How RESULTS helped get TB on the G20 agenda
Despite being the world’s leading infectious killer TB has not been on the agenda of world leaders to date… this may all change thanks to RESULTS and our ACTION partners advocacy which resulted in TB’s inclusion in the G20 leaders statement. Although many people may not realise it the G20 Leaders’ Declaration, released late Saturday 9 July, featured a significant advocacy win for us.
In a section titled Combatting Antimicrobial Resistance (AMR), the Declaration highlighted ‘the importance of fostering R&D [research and development], in particular for priority pathogens as identified by the WHO and tuberculosis’ and the need for a new international R&D hub that maximises the impact of existing research and product development, and develops new market incentives (p. 8-9).
About 700,000 deaths every year are blamed on antimicrobial resistance (AMR) and there have been warnings the toll could rise to 10 million people annually by 2050.The overuse of antibiotics is a global problem that has accelerated the emergence of drug-resistant superbugs.
We worked all year to make the case for the centrality of TB to any discussion of AMR and its importance to Australia, despite our low domestic rates of the disease. The Asia-Pacific bears 60% of the global burden of what is, once again, the world’s deadliest infectious disease and drug-resistant forms of TB are the greatest single cause of antibiotic resistance-related deaths. And even if we were working with some different people and institutions, we still used techniques and tactics familiar to grassroots advocates:
- Making a strong, well-argued case touching on regional and national interests, to key influencers including the Foreign Affairs and Health Ministers, and staff in their Departments,
- Leveraging our existing relationships, such as with the Australian TB Caucus, who have privileged access to their parliamentary colleagues and can make representations directly,
- Building new relationships: for example, with Australia’s Chief Medical Officer, who provided technical advice on AMR to our G20 Sherpa. (The Sherpas represent the G20 leaders at planning meetings and in negotiations prior to the Leaders’ Summit, and are largely responsible for the text of the Leaders’ Declaration.),
- Taking advantage of opportunities, like those presented during the year with visits by the Rt Hon. Nick Herbert MP (co-Chair of the Global TB Caucus) and Dr Eric Goosby (UN Special Envoy on TB). In their meetings in Canberra, both discussed – among others issues – TB within the AMR agenda,
- Making our case in the media, either through the trusted and prominent voices of others or speaking for ourselves and
- Thanking people after we’d met with them, and when we had secured the outcomes we sought.
The G20 (Group of 20) comprises 19 countries plus the EU, collectively accounting for more than 85% of the world economy and nearly 80% of global trade. These nations are also home to about two-thirds of the world’s population, including more than half of all people living in poverty. Beginning in 1999 as a finance-focused gathering, since 2008 the G20 has also hosted a Leaders’ Summit that considers issues beyond the strictly economic such as sustainable development, migration, preventing corruption – and since last year, AMR.
Beginning in January the G20 agenda has been discussed at meetings of G20 Ministers of Agriculture, Foreign Affairs, Finance, Labour and Health, as well as in G20 Working Groups and civil-society Engagement Groups. Key elements of the outcome statements from all these gatherings flow into the Leaders’ Summit, and the text of its final Declaration.
In mid-May RESULTS staff, our G20-based ACTION partners (in Canada, France, India, Japan, the UK, and US) and other TB advocates were delighted at the prominent mention of tuberculosis in the Health Ministers’ Berlin Declaration. Then the push was on again to ensure that TB survived the pressures of selection into the shorter Leaders’ Declaration, and last weekend we had another success to celebrate.
This G20 result follows logically from our collective success in 2016 securing Australia’s increased pledge to the Global Fund to Fight AIDS, TB and Malaria. We discussed then the value of our pledge in saving lives, avoiding future infections, supporting partner countries to make their own health investments and, ultimately, stimulating global economic gains. As Dr Eric Goosby puts it, this is about ‘being part of the global community, being part of the solution because you can be’.
But strong health systems are most effective when they have the best possible tools – and we learned last year that the tools currently used to prevent, diagnose and treat TB need to be more widely-available, effective, faster-acting and cheaper. Encouraging new R&D for TB and finding incentives to develop products from this research will help make that happen.
In the context of AMR, the G20 has placed TB firmly at the centre of political attention. These valuable and hard-won words in an official document now need to be made to work for people with TB. The prominent recognition of TB in an important global forum like the G20 represents another important dimension to the growing momentum for efforts to address TB, as demonstrated by the upcoming Global Ministerial Conference on ending TB Moscow in November, followed by the first ever UN High-Level Meeting on Tuberculosis in late 2018.
Michelle Imison, RESULTS International (Australia) Global Health Campaign Manager and Assistant to the Secretariat, Australian TB Caucus