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Key points
World TB Day 2018 highlighted TB as a large global problem
TB research is lacking yet receives less money than other diseases, despite its mortality
We can all campaign for increased funding for TB!
Saturday (24th March 2018) was World TB Day. National monuments in affected countries were lit up with red lights and there were talks held at universities all over the world. The London School of Hygiene and Tropical Medicine (LSHTM) and University College London (UCL) held a day of talks and debate on Friday to shine a light on the forgotten disease that is tuberculosis (TB).
Most people I speak to in the UK don’t know what TB is, and if they do, they think it was eradicated years ago. In summary, no, we do not have an effective vaccine and yes, TB is still a problem. In fact, TB is the top infectious disease killer worldwide, responsible for 1.1 million deaths in 2015. That’s more than HIV, malaria and Ebola. In the UK, last year there were 6,000 cases of TB. Despite these numbers, TB research receives less than a tenth of global funding than HIV/AIDS and a third of that received by malaria.
TB is a bacterial disease that can affect any part of the body but most of the research has been conducted in pulmonary TB that affects the lungs. TB can be airborne and so very easily transmitted. It is thought that a quarter of the world’s population is infected with TB but many will never develop symptoms. Without treatment, 70% of people with symptoms will die. There are many risk factors for developing disease, including homelessness, diabetes, smoking and HIV. TB is an infection of poverty: many of the most affected countries are also the poorest. Areas such as sub-Saharan Africa, where HIV is a big problem, are particularly at risk of TB epidemics.
People affected by TB often do not have access to health facilities through physically being too far away in rural areas, or not being able to afford to see a doctor. When people do see a doctor, the drugs may not be available and even when they do get drugs, the side effects can be just as bad as the symptoms of TB itself. Compounding the problem is that TB has developed resistance against many of the first-line drugs and some TB is now very hard to treat.
The importance of the lack of funding for TB cannot be overstated. Because there is not enough investment in diagnostics, we still do not have a cheap, reliable test that can be used in rural and remote areas. Because pharmaceutical companies do not see adequate return on investment, there is little incentive for industry to pour money into research and development for new drugs and vaccines. More critical than this, is that due to lack of investment into basic research, we still do not know why some infected people get ill and others do not. Without this fundamental knowledge, we don’t know who to target for preventative treatment to ensure further transmission stops.
This may all seem like an insurmountable task. This World TB Day proved that there is light at the end of the tunnel.
The UN is convening a high-level meeting in September 2018 where world leaders will specifically discuss TB. This has never happened before. The Rt Hon Nick Herbert, a British Member of Parliament and head of the UK All Party Parliamentary Group on TB, attended World TB Day at LSHTM and spoke about the unprecedented opportunity that this year holds. Without the tireless work of advocacy groups and political involvement, the world would not be in a situation where anti-retrovirals can allow a person with HIV to live an almost normal life. The same could be true of TB with adequate political will and funding.
This is something that we can all get involved in. Whether you live in the UK or elsewhere, whether you know anything about TB or not, you can make a difference. To take advantage of the opportunity this year holds, we need the backing of our heads of government. As a constituent, you can write to your MP and ask that they bring up the topic of TB in discussions. You can ask that they petition that your prime minister or president attend the UN high-level meeting in September. Only if they are there can our elected leaders can show the world that TB is important.
Further reading
About me
Final year PhD student at LSHTM working on immunology of infectious diseases, specifically TB. I like using Google Maps to find coffee shops, using Strava to train for triathlon and Skype. I dislike changing GP surgeries.