Tuberculosis and India: Opportunities for Leadership

Indian Prime Minister Modi made bold commitments toward ending TB in India by 2025 and has sustained those commitments in the face of COVID-19. COVID has had devastating impacts on TB program efforts in India and across the world—due to initial lockdowns and to TB program capacity being shifted to fight COVID. But India is leading the way on pushing to scale up ambitious TB-COVID joint response/recovery efforts; this is critical both to regain ground against TB and because effective TB programs offer the best opportunity to develop a response platform for future respiratory pandemics. In addition, Minister of H&FW Mandaviya has just become the chair of the global Stop TB partnership for the next three years and India is helping lead regional efforts in Asia on TB response and financing this fall and is very well placed to drive even more action as G20 host in 2023 (the same year there will be a next UN High Level meeting on TB.)

TB is the leading global infectious disease killer in low- and middle-income countries. TB sickens 10 million people each year and claims 1.5 million lives. TB is airborne, and deadly strains of drug resistance exist in every part of the world. India has the largest TB burden in the world, over a quarter of all TB cases. Worldwide, over 40 percent of people who get sick with TB every year (over 4 million people) are not reached by their health system, and their illness is undiagnosed or unreported. For drug-resistant TB, the rate of undiagnosed cases is an astonishing 78 percent. Death from TB will cost the global economy nearly US$ ONE Trillion over the next fifteen years

COVID 19 has had a devastating impact on TB—with up to 10 years of progress lost in some high burden TB countries due to lockdowns and diversion of TB resources to COVID efforts. TB programs have been the backbone of COVID-19 response, especially in Asia (with infection control facilities, labs, contact investigation, trained pulmonologists, health workers, etc.) TB investments are one of the best buys in development—they build health systems from the community to primary health to tertiary care, including labs and surveillance systems, while curing people and saving lives. Fully resourced TB programs provide a respiratory pandemic response platform to tackle current and future epidemics. The world stands at a crossroad, with less than two years left to reach the UN High-Level Meeting on TB targets by 2023 and four years until India’s 2025 target to end TB. This will require redoubling efforts and investments to urgently close widening gaps in access to much-needed treatment and prevention for the millions affected by this ancient disease.

So what is needed now? Political leadership in continuing to elevate TB as a health priority nationally, regionally and globally. Technical leadership in scaling up TB-COVID joint responses, uptake of new technologies, and engagement across all sectors. Expanded domestic and external resources. India is home to the world’s biggest programmatic effort to end TB; India’s success and leadership in meeting its ambition to end TB by 2025 can put the world firmly on the path to ending this age-old disease. The country is also a regional leader on TB, and a partner with USAID in TB recovery. India is also host of the G20 summit in 2023, the same year as the second UN high-level meeting on TB, an important landmark to bolster political leadership and fast-track efforts to End TB. The G20 summit will be an unprecedented opportunity to mobilize world leaders for a greater political commitment and investment in full restoration of TB services and a respiratory pandemic response platform.

One key area of engagement is to build U.S. congressional and administration support for TB, and elevating India’s leadership on TB globally and increasing support in key states; new US/India joint efforts. There is also a Diaspora role in building knowledge and awareness about tuberculosis to restore and accelerate the diagnosis, treatment and prevention of TB.

For more information, visit results.org, or contact sbekele@results.org.

S Ashish Bali is a former senior leader and executive with forty years’ experience in professional services globally with Deloitte in a variety of roles, including CFO and Audit partner. Currently on the Audit Advisory Board of UNDP and the Board of RESULTS. Ashish also focuses on helping CXOs and Boards review all the various stages of managing a business services firm.

Dr. Joanne Carter has been Executive Director of the anti-poverty advocacy organization RESULTS since 2008. With volunteers in every U.S. state, and advocacy partners on five continents, RESULTS leads advocacy campaigns to create more equitable policies and drive billions of dollars of government investment toward the highest-impact solutions to poverty. RESULTS has been instrumental in increasing U.S. funding for international TB from less than $1 million to over $300 million annually, and Joanne served as Vice Chair of the global Stop TB Partnership Board for the last eight years.