On 24th of March, the University College London (UCL) together with the London School of Hygiene and Tropical Medicine (LSHTM) organised the World TB Day Symposium, which took place at the Institute of Child Health in London. The Symposium gathered the key medical and research professionals from the UCL and LSHTM, with several guest speakers from the WHO, Cambridge University, Borstel Research Centre of the University of Lubeck and the Public Health England.

The Symposium consisted of four panel discussions, with each of the panel participants giving a speech or presenting research results on the topic of the panel discussion. After the presentations audience was allowed to ask questions about the research and topic in general.

The topics of the Symposium included: first of all, the natural history of TB, focusing the response of tubercle bacilli to treatment, and the ways to model the population level impact of TB, as well as identifying pathogenic immune responses in active TB. One of the speakers called the tubercle bacilli fat, lazy and indifferent due ability of the bacteria to shield itself in protective fat, allowing it better to survive the adverse conditions.

Second session explored a very interesting question of sexism in TB, trying to answer why there is a difference of TB prevalence between sexes. According to statistical data, the TB prevalence is equally distributed amongst boys and girls before age of 14, but after the puberty hits, one can see staggering increase of TB cases amongst men – almost twice as much as amongst women. Both researchers and medical professionals are now trying to understand why it is the case. At the moment, no one can definitely point out one reason – it can either depend on the lack of access to TB treatment amongst women or prevalence of harmful behaviours amongst men such as smoking or even impact of the gender on the immune system in a way that is yet unknown.

Third panel discussion looked at the topic of screening latent TB infection in migrant population, with researchers from Germany, highlighting the difficulty of the task due to the different migration pathways (not only limited to Mediterranean region as widely reported in the media) and the changing nature of the migration, with the top 10 countries of origin for migrants changing year to year. However, the researcher also highlighted that each year only few from top 10 countries of origin are high-TB burden countries, thus, opposing the belief of migrants “bringing TB” to the EU MS.

The final panel focused on TB elimination and eradication, discussing the credibility of Stop TB Partnership goals with regards to the results of fighting TB by 2030 (90-90-90goal), and the economic consequences of successful TB treatment and elimination in terms of value for money. Interestingly, the debate regarding credibility of TB community in eyes of the wider world due to the goal of 90-90-90 was discussed in detail, with several participants suggesting that even if it is not realistic to achieve such goal by 2030, it can be used as great advocacy tool with national governments to call for the investment in TB R&D and TB diagnostics and treatment. The current rate of TB decline worldwide of 1,5% is much too low and if the ambitious goals can help with advocacy efforts, then why not use them.

By Anete Cook, Coordinator of TB Europe Coalition


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