Liberia: “Triple Domestic Budget For TB Burden Countries”

The deputy executive director of the Stop TB Partnership has urged high-TB burden nations to at least increase their domestic TB expenditures, which would assist to rescue millions of TB patients.

With a few exceptions, like South Africa, most of the high burden countries in Africa devote very little of their domestic budgets to TB, leaving them dependent on the Global Fund grants that are meager and insufficient, according Dr. Sahu Suvanand, who recently attended the 2022 Global Fund to Fight’s Seventh Replenishment and the UN General Assembly in New york, United States. 

“So a major part of the country's budgets for TB remain unfunded. If adequate funding is not made available for TB, a large proportion of people affected by TB will remain undiagnosed and untreated and TB will continue to be a major cause of death in African countries.” 

Liberia is one of the top 30 TB-endemic nations with over 7,000 cases reported, of which 55 were drug-resistant, according to WHO’s 2021 Global TB report.

During the UNGA, Dr. Suvanand had the opportunity to directly engage with global health and political leaders and discuss the ongoing efforts to end TB, HIV and Malaria. 

Stop TB in cooperation with media organization Devex organized a high-level visibility event on tuberculosis (TB) dubbed “Talking TB: The road to 2030 at the UNGA

The Global Fund Replenishment was the biggest ever in September of this year, with a total pledge of US$14.25 billion, with a few countries left to pledge their contributions. Although the Replenishment’s goal, which was US$18 billion, was not reached, the level of support was still high. 

These funds, according to Dr. Suvanand will be allocated to eligible countrie to fight TB, HIV, and malaria for the next three years. 

In addition to the threat that tuberculosis poses to African nations, Dr. Suvanand claims that malnutrition, HIV, diabetes, poverty, and overcrowding will increase disease rates. Therefore, delaying investment in TB will increase the cost of treatment in the future.

According to him, the disease is an airborne illness with medication resistant forms and extremely high mortality rates, therefore there could be major long-term ramifications if there is insufficient support for the fight against TB in the world, especially in Africa.

“If funding continues to be inadequate the world will not meet the SDG target of ending TB by 2030 and TB could even go out of control posing a global health security threat.”

TB is the 13th leading cause of death and the second leading infectious killer after COVID-19, according to WHO.

Globally, 10 million people develop TB each year and 1.5 million die of it and in Africa 2.5 million people develop TB and 550 000 die due to TB, a staggering 22.5% mortality. 

“Such high mortality is unacceptable because we have tools to prevent, diagnose, treat and cure TB, and more tools such as an effective vaccine are in the research pipeline. Lack of funding is one of the major reasons for this continued high mortality and ongoing transmission of TB, “said Dr. Suvanand.

The TB watchdog urged for extra financing after the WHO's Global TB Report revealed that more than 1.5 million individuals had the disease in 2020, but the call did not have any impact. 

Dr. Suvanand believes this time he calls for stepping up funding comes at a critically important time with new opportunities and possibilities. 

“We saw during the COVID-19 pandemic that if world leaders prioritize a health issue then resources can be mobilized. If it could be done for COVID-19 then why not for TB? He asked?

He further urged that progress made during the COVID-19 pandemic in molecular diagnostics, genome sequencing, contact investigation, digital health and airborne infection control practices can contribute to the TB response. 

“We have also put forth strong reasons to propose TB as a centerpiece of future pandemic preparedness against airborne infections. And if this is done the fight against TB should benefit from additional resources being mobilized for pandemic preparedness and response.  We have new opportunities in the next few years, such as the United Nations High Level Meeting on TB scheduled in 2023 and the G20 Presidencies of Indonesia and India in 2022 and 2023, two of the highest TB burden countries who have prioritized TB within the G20 agenda.” 

He says the organization will also push for inclusion of TB in the G7 agenda that was published,  the Global Plan to end TB which identifies the priority actions and resources needed to end TB and it also elaborates the potential sources of funding, including domestic budgets, the Global Fund and other external funding sources, development banks, social health insurance, private sector and innovative financing approaches. 

“The Global Plan has a total price tag of US$ 250 billion to end TB over the next 8 years but with an impressive return on investments of US$ 40 per dollar invested, accounting for economic returns projected to accrue through 2050.”