The bacteria that cause TB usually attack the lungs
“ For us to get a vaccine by around 2026 , we need to secure sustained funding for every single stage of clinical trials . As you can imagine , the funding is completely unpredictable for this situation , so it derails our target . We don ’ t know exactly what kind of delay we are looking at but for sure we don ’ t expect that this will be finished by 2026 ,” said Dr Ditiu .
Eradicating TB is not just a health issue . According to the Stop TB Partnership , ending TB globally could yield a US $ 1.2 trillion economic return on investment by generating benefits of US $ 33 per dollar spent .
Yet in India , with its enormous population and high relative incidence of the disease , with some 2.7 million annual cases of TB , the cost of the disease is stark , with some weighty reports estimating the economic burden of tuberculosis on the Indian economy at as much as US $ 32 billion a year — three times its annual health budget .
Other countries face similar economic losses through mortality , lost productivity , and costs to their health services . Unless control efforts are stepped up , the cost to the global economy could reach almost US $ 1 trillion , according to one study published in The Lancet .
“ TB is one of the most cost-efficient disease investments . To develop a vaccine and treatment , it ’ s indeed a drop in the ocean . Some of the people that we ’ ve spoken to — bankers and the like — have said to us , ‘ this is probably one of the best investments for which you can put your money ’,” said Dr Ditiu .
She estimates that for research , a new regimen , and a new vaccine , the cost will be around US $ 800 million overall . For a vaccine to get approved , researchers will need about US $ 600 million over the next 3-4 years for trials .
Yet despite the huge financial benefits to governments from spending on a vaccine effort , research investment has been sluggish . For too long , TB was handled by doctors who rarely engaged with other parts of the medical community . Dr Ditiu believes that proposals for TB funding were seldom effectively made to finance ministers and heads of government until recently , when the disease ’ s negative impact on economic development was finally recognised .
In addition , governments themselves did not realise the extent of the problem in their own countries .
“ We were doing some advocacy work with some governments , and in some of the countries with the highest burden of TB , they were simply not aware that TB was such a threat . They would list off other diseases , even though in some places , TB has been the first or second killer of their people . They had no idea .
“ Political commitment towards TB is extremely important . I think it ’ s much more there now , though COVID-19 has affected it so much recently . But since the 2018 UN high-level meeting and declaration , the political engagement has increased , ” Dr Ditiu said .
Southeast Asia is notable for its efforts in addressing the disease , with political commitment and engagement standing out in countries like Indonesia , where President Joko Widodo has called for “ aggressive tracing ” of suspected TB cases across the country to stop the disease being “ overlooked ” amid the drive to control the coronavirus pandemic . In doing so , he emphasised the gravity of the situation , as Indonesia has the third-highest number of cases in the world after India and China , and called on regional officials to tackle TB with the same zeal as with the pandemic .
“ We probably might have to detect both COVID-19 and TB cases simultaneously ,” he told his cabinet in July , adding that he would issue regulations to ensure a steady supply of diagnostics and medication .
A similar political will to push forward the TB agenda has been seen in Vietnam , Bangladesh , and Pakistan , though it has not been backed up by investments in diagnostics and treatment .
“ To do that , it costs a lot of money , and a lot of these countries rely on receiving global funds . But funds have been taken from TB and now they ’ re put into COVID-19 ,” said Dr Ditiu . “ We have to explain that this is really not a great approach , and it cannot happen like this . We have a big problem that is so scary because TB has so little clout . There needs to be more support to really help these governments to secure more funding to address this .” n
Eradicating TB is not just a health issue . According to the Stop TB Partnership , ending TB globally could yield a US $ 1.2 trillion economic return on investment by generating benefits of US $ 33 per dollar spent
GlobalHealthAsiaPacific . com NOVEMBER 2020
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