"I do not want to go into circles in issues that are direct and critical. There is much more TB in my country than estimated."
PIC: Bebe Cool dances with Dr. Ditiu on stage. (Credit: Elvis Basudde)
“Four of my family members -- two sisters and two brothers -- died of tuberculosis. I remember that now. I was a very young boy. They were coughing nonstop. I will never forget one of my favorite sisters.”
These were the moving words of Ugandan musician Moses Ssali, best known by his stage name Bebe Cool.
His audience included artists, footballers TB professionals, activists, global and civil society advocates, ministers of health, first ladies and TB survivors.
Bebe Cool was speaking at the first ever United Nations High Level Meeting on the sidelines of the 73rd UN General Assembly in New York late last month.
“I am practical; that is why I am vocal in my country," he went on.
"I don't want to go in circles on issues that are direct and critical. There is much more TB in my country than estimated. Uganda, like most of Sub-Sahara Africa, is battling with the dual TB and HIV/AIDS epidemic.”
The meeting aimed at building momentum, driving cross-sectoral action, accelerating global and national progress as well as achieving the goal of ending tuberculosis.
Every year, over 10 million people develop tuberculosis. Of this number, an estimated one million are children and another one million are people living with HIV.
Four million people miss out on TB care and treatment. Every year, nearly 600,000 people develop drug-resistant TB (MDR-TB) globally and only one in four people receive treatment.
Meanwhile, Bebe Cool was invited to perform at a related side event dubbed, “Our Night with the Stars-Gala Dinner Celebrating TB Champions.” The events took place from 23-27 September, 2018.
The Ugandan musician got his audience all groovy when he took to the stage and belted out his popular Kabulengane, a traditional Luganda song whose dance strokes thrilled the audience.
“This is how we do it in Uganda,” he demonstrated to Dr. Lucica Ditiu, executive director of Stop TB Partnership Secretariat, who danced alongside him, amidst ululations from the gathering.
Watching @BebeCoolUG & @LucicaDitiu dancing at “Our Night With The Stars” might be the highlight of any global health event, ever. Too cute! Thanks for reminding us that #TB advocacy is about LIFE. #stopTB #endTB #WeAreTB @StopTB pic.twitter.com/BglX7aquAW— Kate O'Brien (@tubercuLOLsis) September 26, 2018
Bebe Cool said he was proud to be invited to raise awareness about tuberculosis, and called upon all countries to unite in raising funding for TB.
He regretted that the person suffering mainly of TB in Uganda is the rural person, who is struck by poverty and struggles to access medication because TB has not been afforded the priority it deserves.
He appealed to heads of states to reaffirm their commitment, saying the conference presented an opportunity to galvanize much-needed attention, resources and accountability to drive progress towards the global community’s ambitious goal of ending TB by 2030.
Ugandan artist @BebeCoolUG #ТБ performed for delegates on the sidelines of the United Nations High Level Meeting on Tuberculosis.#bebecool also courted funders to join the fight. https://t.co/iq8DQKKszi pic.twitter.com/9YOoaD8vle— ЗДОЛАЄМО ТУБЕРКУЛЬОЗ РАЗОМ (@tuberculosis_ua) October 2, 2018
On her part, Dr. Ditiu said that tuberculosis, an airborne infection, is the leading cause of death among infections and the ninth overall leading cause of death worldwide, ranking even above HIV/AIDS.
In 2017, an estimated 1.7 million people were dying of TB.
She regretted that despite progress made in the last two decades, the incidence of TB is not declining fast enough to end the disease as envisaged under the Sustainable Development Goals.
But the good news is that TB is wholly preventable, treatable and curable.
In order to bend the curve on TB, Ditiu said quality-assured drugs, diagnostics and approaches to finding and treating patients should be adopted and scaled up, which will require being more innovative and collaborative than ever before.
Nigeria's First Lady Aisha Buhari, speaking during the conference, urged the relevant stakeholders around the world to make strategic partnership towards tackling TB in Africa. (Credit: Elvis Basudde)
All people developing TB, including drug-resistant TB, need to be diagnosed and treated, and those at highest risk of developing TB (contacts of patients, people living with HIV, etc.) need to receive preventive therapy.
Currently, only about 60% of TB and about 25% of the drug–resistant TB are notified as receiving treatment.
Coverage levels are lower for children and preventive therapy coverage is minimal.
Ditiu said one of the challenges that need to be addressed in order to end TB is the adoption and scale-up of new TB innovations.
The uptake of new innovations for preventing, diagnosing and treating TB remains inadequate for achieving the Stop TB Partnership’s Global Plan to end TB 2016-2020 and the WHO’s End TB Strategy, the latter which includes 2030 targets to reduce the TB incidence rate by 90% and TB deaths by 80%, using 2015 as a baseline.
The availability of new TB products and technologies in a country doesn’t necessarily correlate to adoption, correct usage, scale-up, or significant public health impact.
To-date, experience with new TB diagnostics, in particular, suggests that many national TB programs in high burden countries are unable to adopt and scale-up new tools, even when they are backed by evidence and global policy recommendations, due to issues such as lack of ambition, insufficient funding, training and weakness in health system planning and management.
A key example demonstrating the above is the Xpert MTB/RIF assay, a cartridge-based fully automated nucleic and amplification test (NAAT) for TB case detection and rifampicin resistance testing, which entered the market in 2010 and as of 2016 had over 16 million tests performed in 122 countries.
However, the old technology of sputum microscopy is still the mainstay of diagnosis for most high TB burden countries. The roll-out of Xpert has highlighted the following gaps, which have constrained the tool’s scale-up and limited its impact on patient outcomes.
One, high cost of Xpert for under-funded NTPs, and two, unavailability of a complete solution package, particularly comprehensive training, quality assurance, implementation plans , and service and maintenance support.
The third gap is lack of impact assessments. In addition, the insufficient focus has been given to effective linkage of diagnosis to care of diagnosed patients, and weak health systems have undermined clinical impact.
Meanwhile, the High Level Meeting on TB in New York also announced the new promise for vaccines against tuberculosis.
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