“Some low-income countries are still not aware that tuberculosis is a great killer”

2022-09-23T05:58:13.567Z

Lucica Ditiu, executive director of the Stop TB organization, warns that the budget for the fight against this infectious disease is insufficient

Lucica Ditiu, Executive Director of the organization Stop TB.Stop TB

Lucica Ditiu has been leading the Stop TB Partnership since January 2011. As executive director of this organization, one of the most important in the fight against tuberculosis in the world, she is participating this week in the two parallel events at the 77th General Assembly of the UN in New York related to the disease.

“It is very important that we have these conversations to attract attention,” she says after leaving one of the meetings and before leaving for others.

This attention that Ditiu demands is essential, he says, for the international community to get involved in eradicating tuberculosis.

Despite being treatable, it still kills 1.5 million people each year, making it the second deadliest infectious disease after covid-19.

However, the efforts in research and investment to end one and the other are very unequal.

An example: the 18,000 million dollars that the Global Fund for malaria, tuberculosis and HIV requested from the international community this Wednesday for the next three years is equivalent to what the United States allocated exclusively to the development of the vaccine against SARS- Cov-2, illustrates Ditiu.

Tuberculosis is the second deadliest infectious disease after covid-19.

However, the efforts in research and investment to end one and the other are very unequal

Ditiu's fears were realized.

Despite the efforts of donors who increased their contributions to the World Fund, the largest global entity against the three infectious diseases that kill the most, the desired amount was not reached (at least for the time being).

The amount raised was 14,250 million dollars.

But even if the 18,000 had been raised, it would not have been enough to end tuberculosis, according to the director of Stop TB.

Ask.

What conclusions do you draw from the conversations about tuberculosis that you are attending?

Response.

It is a disease that affects poor people in poor countries.

And that's why it hasn't received adequate attention.

It is very good that we have these discussions.

The important thing is what we do afterwards, when we return home.

Here we hear incredible commitments but, unfortunately, many are not fulfilled.

The Global Fund has raised 14.25 billion, a historic amount.

What does it mean for the fight against tuberculosis?

It is a huge amount.

From a TB perspective, it will be an increase from the $700 million it currently allocates, but we need $5 billion a year from the Global Fund.

So it's a big step, but it's not enough.

What is needed, in my view, is for countries to realize the burden of TB on their own people, and for those that can, to increase their national resources three or fourfold.

If we only depend on money from the Global Fund, we will not go anywhere.

Not only when it comes to tuberculosis, but also to HIV and malaria.

But those countries are, for the most part, poor.

Can they afford it?

They can increase their national budgets, but not that much.

So for them it will be necessary to obtain resources from a bilateral donor, in addition to the Global Fund and their national budget.

It all starts with awareness.

First of the population: that they know what is killing them.

And then, from the key leaders.

We still find low-income or lower-middle-income countries that are not aware that tuberculosis is a great killer.

The countries that can must increase their national resources three or four times.

If we only depend on money from the Global Fund, we will not go anywhere

What is Stop TB's proposal in this regard?

What we need, in addition to money, is for countries to create their national plans that answer a basic question: what do I have to do to end tuberculosis?

How can I reach all the people who live in my country with diagnosis and treatment?

And with the answer, make numbers and budget.

With a comprehensive plan like this (which will be very expensive), you go and say to the Global Fund: I put these domestic resources, this is my gap, can you help me?

We hope that each country plans in this way for its own people, to ensure access.

In addition to funds and awareness, what role does science have in ending the disease?

New tools have to be developed.

We have a good diagnosis, but it cannot be done at home or by organizations like ours quickly.

We have quite good drugs and treatment regimens, I would say, but still with many side effects.

And we don't have a vaccine.

The reason is that tuberculosis research is not attractive.

It is a disease that nobody cares about.

Is there hope for a vaccine or a new treatment?

As for treatments, we have high hopes and new ones have emerged.

And our partners, including the TB Alliance, are working on a vaccine.

With covid we saw that it is possible to get the new immunization in 10 months.

And it is possible to use all the methodology applied for its development to obtain an immunization for tuberculosis.

Countries with a high burden of the disease such as Indonesia, India, Brazil or China have the capacity to develop vaccines.

They should not always wait for the great north to develop them.

India has the Serum Institute, which is the largest vaccine manufacturer in the world.

They already have one, which is not the golden bullet, but it's really good and they're trying to see if they start running it very soon, probably next year.

That is the hope, that high burden countries can acquire it.

The current data, however, do not leave much room for hope.

The fight against tuberculosis has gone backwards.

We are facing figures that we have not seen since 2012. The response against covid-19 was built on the platforms that worked on tuberculosis, since it is also transmitted through the air.

Doctors and nurses in hospitals, infection control measures, laboratories, and even contact tracing in communities that we had prepared for tuberculosis, were redirected to the new disease.

So, for the first time in 10 years, we see an increase in tuberculosis mortality and an increase in the number of undiagnosed people, which means that there is much more transmission than before.

People don't realize that you can't be safe from a communicable disease, wherever you are

In April they launched an alert of the possible increase in cases due to the war in Ukraine.

Do you have data on how it has affected?

There is fear of an increase.

But we have figures showing that Ukraine has done better than we expected.

It is an example for the whole world, because they have not stopped doing screening tests, they will probably have diagnosed and treated more people with tuberculosis in 2022 than in 2021. Our fear is more in the people who went to other countries.

Romania and Moldova are good at detecting cases because they already have a lot of tuberculosis.

However, the countries on the western route, which goes from Poland to the west, which do not have as much tuberculosis, are not used to handling it.

So far we have not seen an increase in the number of drug-resistant tuberculosis in any of these countries, because the few cases from Ukraine that have appeared have been diagnosed immediately or were already on treatment.

The UN has warned that international cooperation is at risk because prosperous countries are focusing on themselves to counteract the effects of the war in Ukraine and covid-19.

How does it affect tuberculosis?

They are focusing on them, yes.

So this was a difficult time for a replenishment for the Global Fund.

The international community, the world in general, is becoming very selfish.

What people don't realize is that you can't be safe from a communicable disease, wherever you are.

Tuberculosis is airborne, it comes from everywhere.

So unless leaders are open-minded, they will continue to think that they can protect their citizens by investing only in the country.

But the world is open and on the move.

It's not a good idea.

As we speak, in a single day, 4,000 people die of tuberculosis, a disease that is curable, for which we have treatment.

It's a crime

You have been at the forefront of Stop TB for more than a decade, and not only is there not enough progress, but now there is a setback in the fight against the disease.

Have you ever thought of giving up?

No, I never give up.

I never give up in general in my life.

If they push me out the door, I go in through the window.

If you throw me out, I'll come back another way.

But are you discouraged?

Yes, it is exhausting.

I often have pure moments of despair, but when I am alone;

I don't let others see me.

I am the head of Stop TB and there are many millions of people who depend on us.

As we speak, in a single day, 4,000 people die of tuberculosis, a disease that is curable, for which we have treatment.

It is a crime, 700 of them are children.