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The Goal of Ending TB is Within our Reach

The United States Agency for International Development (USAID), the lead U.S. Government agency for international TB care, is working closely with the global TB community to expand and improve the quality of TB diagnosis, care, and treatment programs aimed at reducing TB-related mortality and preventing the development of drug-resistant TB.
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Today is World TB Day. Around the world, people are coming together to celebrate progress in reducing TB's human toll and build upon ambitious plans to end the TB epidemic, such as the END TB Strategy, the Global Plan to END TB, and the U.S. Government's Global TB Strategy. These plans call for the rapid adoption and expansion of new tools, medicines, and approaches to TB care. Recent innovations are enabling us to find more TB cases earlier and diagnose TB and multidrug-resistant TB (MDR-TB) more quickly and accurately. These improvements, combined with new drugs and promising evidence on shorter MDR-TB regimens, are enabling us to improve outcomes for TB patients around the world, even those suffering from the deadliest forms of MDR-TB.

The next five years are critical in the fight to end TB. We have a historic opportunity to turn the tide on an age-old killer that has plagued mankind for generations, and the goal of ending TB deaths in our lifetime is within reach. The Stop TB Partnership calls for a paradigm shift by dramatically changing the way TB programs are run. There is good news as we have made significant progress in addressing the epidemic. Over the past 15 years, the global community has saved 43 million lives, cutting the number of TB-related deaths by almost half and reducing the number of new TB infections by over 40 percent. The 2015 Millennium Development Goal of halting and reversing TB incidence has been achieved.

Despite significant progress in addressing the epidemic, we need to accelerate our efforts to eliminate TB as a global health threat. TB is still the world's leading infectious killer, taking the lives of 4,000 people each day, while drug-resistant strains of TB are becoming more and more prevalent. We must take urgent action to reach every person suffering from TB, including those with MDR-TB; cure those in need of treatment; and prevent new infections.

The United States Agency for International Development (USAID), the lead U.S. Government agency for international TB care, is working closely with the global TB community to expand and improve the quality of TB diagnosis, care, and treatment programs aimed at reducing TB-related mortality and preventing the development of drug-resistant TB.

USAID is focusing its investments on working closely with national TB programs in 23 countries with high TB burdens and providing technical assistance to strengthen the implementation of their national TB strategies. Since 2009, USAID has supported successful TB treatment for over 10 million people, helping affected individuals and their families live long, healthy, and productive lives. In USAID-supported countries, more than 60,000 MDR-TB patients were started on treatment in 2014, and over 220,000 TB patients were successfully treated during 2009-2014.

USAID played an active role in the development of the U.S. Government's National Action Plan for Combating MDR-TB and is leading the international component of this plan. USAID is building upon existing initiatives and developing innovative strategies to achieve the ambitious goals outlined in this plan. By the end of 2016, the U.S. Government aims to start 25 percent of MDR-TB patients on appropriate treatment in 10 countries with the highest burdens of MDR-TB. But we cannot do this alone, which is why we will continue to work hand in hand with national TB programs, global partners, and affected communities to achieve this goal.

USAID is encouraging partners to increase their investments in combating TB and to join us in developing new and improved approaches to TB diagnosis and treatment, and in scaling-up these new approaches and tools.

We are inspired by the leadership of countries like South Africa and Pakistan that have increased their domestic investments in TB care, adopted cutting-edge approaches to TB diagnosis and treatment, and have dramatically expanded access to TB and MDR-TB diagnosis, treatment, and care. Over the past three years, Pakistan has had a six-fold increase in the number of MDR-TB patients initiated on treatment. In addition, Pakistan recently published their first nationwide drug resistance survey using innovative TB diagnostic technologies like GeneXpert. USAID provided technical assistance support for this survey, which provides important data for understanding the magnitude of the problem and where interventions are needed. In 2014, South Africa started over 12,000 people on MDR-TB treatment, including 500 people diagnosed with extensively drug-resistant TB (XDR-TB).

The private sector has also demonstrated a strong commitment to ensure the success of the National Action Plan to Combat MDR-TB. For example, Janssen Pharmaceuticals recently announced a $15-20 million pledge as part of a new partnership with USAID to fight MDR-TB, building on its three-year, $30 million donation of a new, life-saving MDR-TB drug, bedaquiline. USAID is partnering with Cepheid, a maker of molecular systems and tests, to find the missing 3.6 million TB cases earlier and accelerate the diagnosis of MDR-TB through increased access to rapid, accurate diagnostic tools. Additionally, USAID is working closely with the Stop TB Partnership's Global Drug Facility to increase access to delamanid, another new life-saving drug approved to treat MDR-TB. These partnerships dramatically expand USAID's ability to save lives in countries hardest hit by the devastating TB epidemic.

In addition to successful partnerships, increased investments, and scaling up the use of new tools, we will need a sustained focus on research to effectively prevent, diagnose and treat TB. USAID continues to support clinical trials that are evaluating the effectiveness of new treatment regimens for TB and MDR-TB. The STREAM clinical trial is an example of such an investment. Initially designed to evaluate a nine month regimen for the treatment of MDR-TB, the trial has expanded to include the evaluation of two additional regimens that are looking at a short 6-month treatment course and a regimen that includes bedaquiline. USAID is also supporting trials to evaluate short treatment courses for latent TB infection in people at high risk of developing the disease. If shown to be effective, such regimens could play a major role in reducing TB incidence and eventually contribute to the elimination of the disease. Finally, USAID is supporting evidence-based ways to treat TB, such as genome sequencing, that identifies patterns of transmission in order to develop highly effective interventions to fight TB.
Over the past twenty years, the world has made some significant progress in combating TB. We need to build upon this remarkable progress and continue to innovate, invest and collaborate to achieve ambitious goals, such as those outlined in the White House National Action Plan for Combating MDR-TB, and ultimately, end TB. Together, we can achieve this.

[For more information, please visit USAID's tuberculosis page]

This post is part of the 'The Isolation of Airborne Cancer' series produced by The Huffington Post for World TB Day. This series will look at the devastating issues surrounding tuberculosis, the number one infectious killer. To follow the conversation on Twitter, view #WorldTBDay.