Denarau, Fiji – While there has been remarkable progress in the fight against tuberculosis (TB) in the Western Pacific region over the past two decades, the disease remains a major public health problem and a renewed effort is required to end the epidemic, said public health experts who gathered this week in Fiji for a regional TB meeting.
The Eighth TB Control Meeting for the Pacific Islands was jointly organized by the World Health Organization (WHO) and the United Nations Development Programme (UNDP) with Global Fund support in partnership with the Fiji Ministry of Health & Medical Services. More than 80 participants attended the three-day meeting, including representatives from governments, civil society, key affected population groups, academia and development partners.
“TB prevention, care and control will both benefit from and contribute to the achievement of the Sustainable Development Goals (SDGs),” said Bakhodir Burkhanov, Country Director and Head of Regional Policy and Programme at UNDP Pacific Office in Fiji, in his opening remarks of the meeting. “The task of TB elimination is challenging but achievable. It requires coordinated implementation of appropriate interventions across sectors and geographic areas in a manner that sustainably addresses the underlying drivers of TB.”
The focus on SDGs offers a way to address TB risk factors and common health system bottlenecks through addressing various determinants of TB, such as provision of universal health coverage, access to quality care and essential medicines, and reducing inequality within and among countries.
At the meeting, stakeholders collaborated to identify priorities and develop specific regional and national actions to operationalize the Regional Framework for Action on Implementation of the End TB Strategy in the Western Pacific, 2016-2020 which was endorsed by Members States at the 66th Regional Committee for the Western Pacific in October 2015. The framework adapts the global End TB Strategy to the situation of Pacific island countries and calls for bold national efforts to fulfil a vision of zero deaths, disease and suffering due to TB by the year 2030, in line with the SDGs.
“Stigma, discrimination and financial burden associated with TB have devastated families throughout the region,” said Dr Nobuyuki Nishikiori, Regional Coordinator, Stop TB & Leprosy Elimination, WHO Regional Office for the Western Pacific. “Basic TB services are free in nearly all countries; however, patients continue to suffer a heavy financial burden from lost income and other expenses. These challenges are serious, but we can overcome them by working together, adapting innovations and dynamically responding to changing environments.”
“We cannot deny the reality which lies before us, TB is again becoming a global emergency,” said Philip Davies, Permanent Secretary for Ministry of Health and Medical Services in Fiji. “To successfully address TB, we should take bold steps to address the determinants of health which governs our susceptibility to acquire this disease. This calls for multi sectorial involvement. This calls for active participation of government, the private sector as well as the community.”
Progress on reducing the burden of TB in the Western Pacific region has been striking – the Global WHO TB Report 2016 reported that prevalence has been lowered by more than 55 percent and deaths by 78 percent since 1990. Treatment has been ramped up as well, with about 1.4 million people currently receiving treatment per year. Yet, despite all of the gains, an estimated 1.6 million people are still contracting TB each year, killing 100,000 people annually in the Western Pacific region.
TB also disproportionately affects vulnerable populations, such as children, the elderly, people in underprivileged and remote island communities, and people with co-morbidities, particularly HIV and diabetes.
There are a number of challenges for Pacific island countries and territories to overcome in order to effectively control the TB epidemic and ensure universal access to quality care for all people.
“In any discussions about TB, one must consider the patient and the psycho-socioeconomic challenges that they face,” said Mesake Navugona, Member of the Fiji Country Coordinating Mechanism for the Global Fund grant for AIDS and TB, and a TB survivor. “One such issue is the stigma associated with the diagnosis of TB, which although unfounded can cost a patient his/her livelihood. All stakeholders need to work hand in hand in hand to decrease the out of pocket payments for TB services and for greater employment protection for patients suffering from this curable disease.”
The meeting featured sessions aimed at addressing these challenges and exploring emerging issues in the TB response, including controlling the disease among high risk populations, addressing drug-resistant strains of TB, patient-centred care and social protection, and strengthening research and innovation.
“It is important to recognize that diabetes increases the rate of TB and also makes TB treatment more difficult,” said Dr. Richard Brostrom, TB Control Branch Chief, Centre for Disease Control and Prevention, Honolulu, United States of America. “It is exciting to see that many of the Pacific island TB programmes, especially the high burden TB countries, have implemented diabetes screening for their TB cases. Some countries have also begun to screen for TB in their diabetes clinics in order to find TB cases earlier and improve safe and successful TB treatment.”
Great strides in TB control in the pacific region have been achieved over the past decade due to the funding support of development partners, particularly the Global Fund and Australia’s Department of Foreign Affairs and Trade. Future TB control will also be dependent on ongoing financial support that addresses funding gaps.
The Eighth TB Control Meeting for the Pacific Islands was supported by WHO and UNDP through the Multi- Country Western Pacific Integrated HIV/Tuberculosis Programme, a regional programme supported by the Global Fund which aims to improve the coverage and quality of HIV and TB treatment and care in 11 Western Pacific countries.
Ian Mungall, Programme Analyst, HIV, Health and Development, UNDP Bangkok Regional Hub, email: email@example.com
Soneel Ram, Communications Officer, Grant Management Unit, Ministry of Health & Medical Services, Fiji, email: firstname.lastname@example.org; mobile: 990 6368