Unless the tuberculosis (TB) advocates reach out to decision makers to impress upon them the urgency of strengthening TB care and control programmes, the global economic meltdown is likely to threaten to reverse the gains made in TB care over past decades. “I believe we should not lower our sights one bit. Rather, we should broadcast far and wide irrefutable arguments for more and better TB control now.

The fight against TB is more than a humanitarian cause – it is also a smart investment, at a time when many investments seem insecure” wrote Dr Marcos Espinal,  on this blog. Time is running out. How can the world begin to see TB care as a smart investment? The cross-cutting linkages of TB control to other development issues – need to be more highlighted, more pronounced and worked upon in terms of advocacy, outreach and engagement. For example, those working on poverty, health systems, HIV, and other connected issues, need to say the same – ‘TB control is a smart investment!’ For instance, at least in high burden TB countries, with TB continuing to the biggest cause of death for people living with HIV (PLHIV), the AIDS advocates should be the lead partners in TB care initiatives – they are demonstrating the leadership in some communities but this certainly needs to be happening more often wherever synergy is most appropriate. TB and HIV programmes need to join forces to improve TB and HIV responses locally. With the economic recession taking its toll in the developing world as well, the need to forge effective and genuine partnerships with different stakeholders was rarely so compelling! Promoting greater transparency and participatory approaches in our efforts to engage allies in TB care and control, might prove to be definitive on how effectively we can convince the world that TB care is a smart investment.

In this time of economic uncertainty, which some are calling the winter of our hardship, people engaged in the fight against tuberculosis may believe we face hard choices. We can’t do everything we planned in 2009 – so what will we sacrifice? Where do we cut?

 

Some may be asking these questions, but I will not. I believe we should not lower our sights one bit. Rather, we should broadcast far and wide irrefutable arguments for more and better TB control now. The fight against TB is more than a humanitarian cause – it is also a smart investment, at a time when many investments seem insecure.

 

A little more than a year ago a World Bank research report found that countries with the world’s highest numbers of TB cases could earn significantly more than they spend on TB diagnosis and treatment if they signed onto the Stop TB Partnership’s Global Plan to Stop TB. The study, which was commissioned by the World Bank on behalf of the Stop TB Partnership and funded by the Bill and Melinda Gates Foundation, made abundantly clear that the economic benefits of TB control are greater than the costs. Most highly affected countries could gain nine times or more their investments in TB control.

 

The study was published a year ago, but we have only begun the work of persuading decision makers everywhere that fighting TB is a matter of economic survival for many, many countries.

 

It’s our job to convince them. If we don’t, budgets for TB control and research will almost certainly be cut.

 

You can bank on that.

 

I really wish that I could go to the Stop TB Partnership Forum in Rio. Unfortunately I need to have a vaccine for yellow fever, however it is a live vaccine. I am HIV-positive and my CD4 count is very low and I have been advised by my doctor against having it. Hey ho! But it doesn’t stop me from participating in ways, for example in this blog.
 
I have worked in the field of TB since 1995. I was inspired to get involved because of my own experience of MDR-TB, and on learning that multidrug-resistance is a man-made problem. It makes sense to me that the solution must therefore be man-made also. I wan’t to play my part in being part of the solution.
 
I wonder sometimes what motivates other people, especially the TB/MDR-TB affected community to get involved. It isn’t the money that is for sure, LOL! For me the motivation is my anger. How can we have gotten to this place? The crisis the world faces on TB is shocking and unacceptable.  I want to channel my anger into something constructive. I know for some others motivation springs from a  sense of injustice about inadequate access to treatment in their own countries, for some it may even be a religious, or spiritual calling? I am interested to know what other instincts or reasons inspire and motivate others to get involved in the battle against TB.