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Opinion Pieces Discuss Global Efforts Needed To End TB Epidemic

The Conversation: Why community and not confinement will end TB
Eric Friedman and Drew Aiken, both researchers at Georgetown University

“…Without a response to TB based in human rights — including moving rapidly to community-based care and improving the conditions in prisons — we believe that progress will remain fatally slow. … To end TB as a public health threat by 2030, … countries should urgently change their laws and their practices to conform to both the right to health care and the most effective public health practices. That means ensuring everyone has access to comprehensive quality health services and ensuring everyone the nutrition, adequate housing, and other underlying determinants of health to which all people are entitled. … [C]ountries must unite to end the era where confinement and punitive measures are routinely used as a response to TB. Instead, they should establish a new era, one marked by community-based care, informed by evidence and human rights-based approaches” (3/23).

STAT: World leaders have the power to end TB. They must seize the moment
Eric Goosby, U.N. secretary general’s special envoy on TB, and Michel Kazatchkine, special adviser to UNAIDS for Eastern Europe and Central Asia

“….As we mark World TB Day and eagerly await a U.N. meeting on TB in September, we must work to sustain this commitment and build upon it to truly achieve a TB-free world. … Ending TB requires political will. Specifically, the global community must unite around efforts to develop better tools to diagnose TB and get to the ‘forgotten’ four million who have not been detected; build upon what we know works to prevent, detect, and treat TB; and enact universal health coverage that will help reduce the number of deaths due to TB and other infectious and noncommunicable diseases. Ending TB also means addressing the growing threat of multidrug-resistant TB (MDR-TB). … We must not miss this historic opportunity. Let’s seize the moment and end TB once and for all” (3/27).

Project Syndicate: The Neglected Solution to the TB Crisis
Joanne Liu, international president of Médecins Sans Frontières, and Paul Farmer, co-founder of Partners in Health, professor at Harvard Medical School, and chief of the Division of Global Health Equity at Brigham and Women’s Hospital

“…This September, the United Nations will host its first high-level meeting on the TB crisis. U.N. member states should use the occasion to pledge a radical increase in funding for TB programs around the world, and to overhaul an R&D model that has proved unfit for purpose. … Specifically, what we need are simpler, quicker, and cheaper ways to test and treat TB, especially in remote and impoverished settings. We need better tools to prevent infections in the first place, and to kill latent infections before they kill us. And, of course, we need a robust pipeline of drugs to ward off TB and its resistant forms. … A U.N. meeting is a golden opportunity to make progress. … [I]t is a chance finally to elevate TB to the World Health Organization-designated status of a ‘public health emergency of international concern,’ as was done in wake of the Ebola and Zika outbreaks…” (3/26).

The Conversation: How to help people with tuberculosis avoid the medical poverty trap
Tom Wingfield, NIHR academic clinical lecturer and LIV-TB collaboration lead at the University of Liverpool

“…A more holistic approach to TB control is needed that addresses not just the disease but also the person who has the disease and the circumstances in which they live. In its 2015 End TB Strategy, the World Health Organization (WHO), for the first time in the modern era of TB control, called for social support and poverty alleviation strategies for people with TB to reduce the hidden costs of treatment, reduce stigma, empower patients, and increase TB prevention, the number cured, and their overall well-being. … Helping households affected by TB to avoid the medical poverty trap, and providing them with moral support and hope, can enhance TB care and prevention. Without it, we won’t achieve the End TB Strategy goal of eliminating the disease by 2050, and millions more vulnerable households … could continue to suffer an entirely avoidable downward spiral of poverty and ill health” (3/22).

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