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Ending Tb in the Sustainable Development Era: a Multisectoral Response 16--17 November 2017, Moscow, Russian Federation

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Ending Tb in the Sustainable Development Era: a Multisectoral Response 16--17 November 2017, Moscow, Russian Federation FIRST WHO GLOBAL MINISTERIAL CONFERENCE ENDING TB IN THE SUSTAINABLE DEVELOPMENT ERA: A MULTISECTORAL RESPONSE 16--17 NOVEMBER 2017, MOSCOW, RUSSIAN FEDERATION CONFERENCE HIGHLIGHTS THE CHALLENGE OF ACCELERATING TO END TB In spite of progress being made towards ending the resistant TB (RR-TB) and multidrug-resistant TB (MDR-TB), tuberculosis (TB) epidemic and 53 million lives having which require longer and more costly drug regimens; they been saved between 2000 and 2016, the challenge of this present a serious antimicrobial resistance (AMR) threat to ancient disease remains significant. Tuberculosis (TB) is global health. The WHO End TB Strategy, adopted by WHO the leading infectious disease killer and one of the top ten Member States in 2014, set ambitious targets to tackle this causes of death worldwide. With a timely diagnosis and deadly disease. Together with the United Nations (UN) correct treatment, most people who develop TB disease can Sustainable Development Goals (SDGs), it guides all efforts be cured. Unfortunately, this is not the case for rifampicin- towards the goal of ending TB by 2030. 1.7 MILLION PEOPLE 53 MILLION LIVES SAVED DIED FROM TB IN 2016 BETWEEN 2000 AND 2016 TB is the main cause of deaths related TB deaths fell by 22% to antimicrobial resistance and the leading in the same period killer of people living with HIV US$ 2 US$ 1.2 BILLION BILLION GAP GAP ONLY 1 IN 5 PEOPLE US$ 2.3 BILLION NEEDING TREATMENT FOR FUNDING GAP FOR MULTIDRUG-RESISTANT TB TB IMPLEMENTATION IN 2016 RECEIVED IT GAP OF OVER US$1.2 BILLION PER YEAR FOR TB RESEARCH CONFERENCE AIMS, GOALS AND OUTCOMES The First WHO Global Ministerial Conference on Ending TB in from which to address the many complex issues linked to the Sustainable Development Era: A Multisectoral Response TB. Four plenary sessions and ten parallel panels provided aimed to accelerate implementation of the WHO End TB a framework for high-level discussions, informed by policy Strategy, through commitments and calls for immediate action briefs which were developed over months of consultations. The to address gaps in access to care and the MDR-TB crisis. This Conference marks an unprecedented period of opportunity acceleration is needed in order to reach the End TB targets to achieve major results towards ending TB. The upcoming set by the World Health Assembly, achieve the SDGs, as well UNGA HLM is another clear signal that the time to act is now. as to mobilize national and global commitments, deliverables The key outcome of the Conference was the Moscow and accountability. The Ministerial Conference will inform the Declaration to End TB, adopted by almost 120 WHO Member UN General Assembly (UNGA) High-Level Meeting (HLM) on States present in Moscow. The development of the Declaration TB in 2018. began in early 2017 and involved partner and Member State The Conference was timely – TB is a global issue that inflicts consultations, led by the Russian Federation. It addresses the a heavy burden on countries not only in terms of health, but four outcome areas of the Conference and states commitments across multiple sectors. Therefore a multisectoral approach from Member States, as well as calls for action at global and with a high level of political will is needed to end this disease. regional levels on the part of WHO and a wide range of partners. Structured around four crosscutting outcome areas and five The present document provides highlights from the Moscow thematic tracks, the Conference was a powerful platform Conference, including summaries of speeches and the main points of discussions. It was attended by 1000 participants, including 79 government ministers and almost 120 partners organizations. For more information and access to all documents please visit http://www.who.int/conferences/tb-global-ministerial- conference/en/ 1 CIVIL SOCIETY CONSULTATION Dr Tedros Adhanom Ghebreyesus, Director-General In his welcoming remarks, Dr Tedros stressed his interest and of WHO met about 100 civil society participants of commitment in establishing a regular mechanism of engage- the WHO Global Ministerial Conference on Ending TB ment with civil society and TB advocates to work together to on November 16, 2017. This meeting was his first end TB with emphasis on universal health coverage (UHC), engagement of the Ministerial Conference also attended primary health quality care and advancing research for better tools. Six civil society representatives selected by participants by the Minister of Health of the Russian Federation at the meeting (Alexander Chuykov, Blessina Kumar, Zied and WHO Regional Directors. Mhirsi, Mandy Slutsker, Khairunisa Suleiman, and Ezio Tavora) met the Director-General and senior WHO staff the following day to discuss next steps. To view the event video, more photos, and for additional information, please visit http://www.who.int/tb/features_archive/civilsociety_ consultation_moscow2017/en/ 2 WELCOME ADDRESSES Tedros Adhanom Ghebreyesus Director-General of the World Health Organization Moscow is a symbol of progress and hope in the fight against tuberculosis. It is the perfect place to hold this Conference – the Russian Federation has made incredible advances against the epidemic. Veronika Skvortsova the Minister of Health of Tedros Adhanom Ghebreyesus, the Director-General of the the Russian Federation World Health Organization, noted that between 2000 and 2016, global efforts to fight TB saved 53 million lives. Such encouraging results should be recognized. But the burden The First Global Ministerial Conference will be of suffering and death due to this ancient disease remains the consolidating platform for the development immense. Like so many diseases, TB strikes the poorest and and formulation of strategic areas and plans most marginalized communities the hardest. To truly end TB, agreed by WHO Member States with a view to all communities must be reached and barriers such as stigma eliminating tuberculosis in the near future, both and discrimination must be eliminated. Another priority is globally and nationally. multi-drug resistant TB which has been undermining progress in the fight against TB for decades and which poses a major health security risk. The Director-General highlighted the Veronika Skvortsova, the Minister of Health of the Russian gravity of the problem but also looked to the future: “Last year, Federation, highlighted her country’s efforts to end tuberculosis: more than 10 million people fell ill with TB, and 1.7 million “Average rates of reduction of tuberculosis mortality have men, women, and children lost their lives. That’s three people exceeded 11% annually since 2011. In 2016 tuberculosis every minute. In the time it takes me to address you today, mortality in the Russian Federation fell by more than 15%, and tuberculosis will have killed more than 20 people. “Next year’s to date in 2017 by 17%. Over the past eight years, TB mortality High-Level Meeting on Tuberculosis at the United Nations fell by 66% and TB incidence fell by 36%. Over the past General Assembly is the opportunity many of us have been eight years, TB mortality fell by 66% and TB incidence fell by waiting for. We may never get another like it. History will be 36%.” In line with the national strategy and the national plan of our judge.” action, every region is putting into effect a regional TB mortality reduction plan. A unified national register of TB patients serves as an important tool for monitoring the epidemic, assessing the quality of care and informing decisions. Nevertheless, important concerns still need to be addressed, in particular multidrug-resistant TB and TB-HIV coinfection. This meeting is attended not just by ministers of health, but by ministers from across government, which demonstrates the real possibilities of a multisectoral approach to address TB. Determination and unity will be critical to achieve the Conference vision and commitments, and work towards the United Nations General Assembly high-level meeting on tuberculosis in 2018. To read the full speeches and view photos and videos, please visit http://www.who.int/tb/ministerial_conference_ proceedings/en/ 3 Zsuzsanna Jakab Timpiyan Leseni the WHO Regional TB survivor Director for Europe As TB is a global health problem, I would like to At that point I’d made up my mind – I said bring emphasize that this conference should be considered it on. Because it wasn’t me anymore it was my an excellent platform to explore and expand Maasai community. interregional collaboration to end TB together. Timpiyan Leseni, from Kenya, developed abdominal tuberculosis Zsuzsanna Jakab, the WHO Regional Director for Europe, in 2011. Because of difficulties in diagnosing the disease, emphasized the successes in decreasing TB rates and she underwent two surgeries and dropped to 36 kilograms in mortality in the European Region, the host WHO Region for bodyweight before getting started on proper treatment. Months the Conference. “I am proud to highlight that our region is of painful TB injections and difficult-to-swallow drugs are not advancing strongly on reforms to link disease control and easy to bear – at times, Timpiyan would tell her family “I am health systems resilience, and ensuring people-centred care ready to die, I can’t take any more injections”, but thanks to for better health outcomes”. However significant challenges her mother’s support she fought on. Now, she wants to help her remain: action on MDR-TB must accelerate, while the Maasai community whose staple diet is beef and dairy, which increasing number of new HIV infections is cause for concern. makes them vulnerable to zoonotic TB. Without awareness The Tuberculosis Action Plan for the WHO European Region and support, people will continue to suffer from this epidemic. 2016–2020 strives to address these challenges, in conjunction with strong, resilient health systems and a focus on equity.
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