Dr Lucica Ditiu
Executive Director, Stop TB Partnership
Dr Suvanand Sahu
Deputy Director, Stop TB Partnership
More than a million people die each year from tuberculosis (TB), a disease that many think belongs in the past. The key to fighting it is better funding, say experts.
Tuberculosis remains the deadliest infectious disease, according to the World Health Organization (WHO). It is known as the ‘orphan’ disease because it has less visibility than malaria or HIV — and less funding, too.
Tuberculosis as the ‘orphan’ disease
It’s a view that Dr Lucica Ditiu, executive director of the Stop TB Partnership, is passionate about changing. The partnership works to advocate for TB sufferers, provide treatment for all, stop transmission, reduce TB’s social and economic toll and develop tools to fight it.
“High-income countries consider TB a disease of the past,” she says. “They don’t realise they have TB in their own countries. London has, in parts, rates that are higher than some high-burden countries.” The death toll is despite TB being treatable, curable and, crucially, preventable.
Ending the TB stigma
One of the difficulties is the stigma surrounding TB — “more than with HIV,” says Dr Ditiu. “People who have HIV and TB prefer to speak about HIV, not tuberculosis.” This leads to a lack of funding, preventing large-scale awareness campaigns in low and middle-income countries which have the highest burden.
Ignorance is also a danger, Dr Ditiu adds. “People are very scared. The fear is coming from a lack of knowledge.” As many as a quarter of the world’s population — 2 billion people — are infected with the TB bacteria. Perhaps only 20% will develop full TB, but that’s 400 million people. Some 10 million develop the illness every year. Anybody can get it, despite its association with poverty and poor living conditions. “We had a lawyer from London, and she had TB,” says Dr Ditiu. “Nobody tested her because they couldn’t imagine that such a brilliant, sparkling girl could have it.”
There are some exciting new diagnostics,
including rapid molecular tests and
AI-enabled portable X-rays for screening.
The battle for funding
Funding is crucial to the fight. HIV/AIDS and malaria take the lion’s share (50% and 32%) of USD 5 billion a year from the Global Fund to Fight AIDS, tuberculosis and malaria while TB gets just 18%. This so-called ‘disease split’ is unfair, says Dr Suvanand Sahu, Stop TB’s deputy executive director.
“If the Global Fund has to fulfil its mandate and reduce deaths due to all three diseases, it cannot achieve it by underfunding TB,” he says. The Global Fund and Stop TB have recently signed a new accord to help move towards ending TB in high-burden countries by 2030. “If we have the money, it’s achievable,” Dr Ditiu insists. “You need to diagnose and treat people at scale.” She believes individual countries must step up: “We see huge ambition from countries like Indonesia, the Philippines, Bangladesh, Pakistan and Nigeria with huge increases in diagnosing and treating people.”
Covid-19 response should show us the way
Dr Ditiu says the Covid response shows that political will and funding can be there: “Look how much the world mobilised when people were threatened by Covid. Even the country with the lowest health budget was able to provide live data, vaccinate and diagnose people at incredible rates; why is similar engagement not happening for TB — also an airborne pandemic?”
There was some good news in the WHO’s annual report on tuberculosis, says Dr Sahu, with 8.2 million people diagnosed and treated in 2023, more than any other year. Yet, he adds, there is more work to do on drug-resistant TB, one of the biggest AMR issues. The WHO estimates about 400,000 people develop drug-resistant TB each year. Although deaths have fallen, the incidence of TB has not, jeopardising one of the UN’s Sustainable Development Goals for 2030.
However, says Dr Sahu, there are some exciting new diagnostics, including rapid molecular tests and AI-enabled portable X-rays for screening. “The tools are there,” he adds. “What is lacking is the ability to scale up and provide access to everybody. To realise the potential, we need funding.”
