The COVID-19 pandemic has disrupted much of the research and development are done in the field of tuberculosis (TB) prevention like a vaccine, diagnostics, and treatment measures, as well as shifted the focus away from TB care. Lockdowns and the high burden placed on national healthcare systems have prevented patients from accessing TB diagnostic and treatment services, and it is expected that this will contribute to a significant rise in TB cases worldwide, thus reducing the chances of achieving the SDG, EndTB, and UN HLM targets.

TB is also the world’s only major drug-resistant disease that is transmitted through the air and these drug-resistant strains have been found in nearly every country in the world. The EU Council Conclusions from May 2019 noted this threat with great concern. The spread of DR TB is of particular concern in Europe, as the region carries up to 25% of the global multidrug-resistant TB (MDR TB) burden, with the burden predominantly focussed in the former Soviet Union states.

One of the critical factors in ending the epidemic will be achieving the target of US$2 billion per year in research and development for TB funding set at the UN HLM. The EU and EU member states have a critical role to play in funding this lifesaving research while supporting Europe’s thriving TB research community and valuable global partnerships, especially in a post-pandemic period with more financial constraints worldwide.

On World TB Day (24 March) the MEP Lung Health Group, organised an event in collaboration with the Global TB Caucus and TB Europe Coalition to bring attention to this important issue with the event, ‘Tuberculosis research and investment – lessons learned from the COVID-19 pandemic’, hosted by MEP Manuel Pizarro (S&D, Portugal, and co-chair of the MEP Lung Health Group).

The event was chaired by Dr. Raquel Duarte, Secretary of ERS Assembly 10 (Respiratory infections), and was joined by an expert line-up of speakers including from the Global TB Caucus, Treatment Action Group, Stop TB Partnership, the Global Fund, Deutsche Stiftung Weltbevölkerung, the DG Research and Innovation (EC), and 2 affected community voices. 

The event focused on bringing awareness to the current state of the TB epidemic, both globally and within the EU; the challenges and opportunities for research and development in the field of TB in the context of the COVID-19 pandemic, and; the role that the EU is playing in addressing these challenges.

During the discussions, MEP Manuel Pizarro started the event by highlighting the need for both global solidarity and support from the scientific community, as the COVID-19 pandemic is causing challenges for the TB response. 

Baroness Suttie from the Global TB Caucus stated that “The main obstacle to ending TB is the lack of political will, and that the EU and European countries have a vital role to play in ensuring funding for lifesaving research is not impacted by the pandemic.” 

Following on, Suvanand Sahu from Stop TB Partnership delivered a presentation addressing the opportunities and challenges facing TB in light of COVID-19. He touched on the progress towards the achievement of the UN HLM TB targets and the SDGs, and also presented opportunities to be taken from the pandemic such as enhanced screening and testing, sophisticated track and tracing tools, and investment in community health systems.

Suraj Madoori from Treatment Action Group addressed TB R&D missing tools and the current financing landscape. He highlighted how TB R&D is being impacted in many ways by COVID-19, and the majority of donor countries still aren’t reaching their TB R&D fair share funding targets.

The discussion looked at how COVID-19 has impacted people with TB. We heard personal experiences from two individuals who either have or did have TB, which provided more context to the previous discussions. Maria, from Romania, spoke about how it took a significant amount of time for her to eventually get diagnosed with DR-TB, after initially receiving the wrong diagnosis. She spoke not only about the physical impacts of living with TB but also the mental impact that being diagnosed with TB at the start of the COVID-19 pandemic had on her. Nandita Venkatesan then spoke about her experience of contracting and then recovering from TB. She stressed that the COVID-19 vaccine took less than one year to be produced, and this same energy and amount of investment is needed to improve TB treatment.

Scott Boule discussed accelerating the end of TB from the perspective of The Global Fund to Fight AIDS, Tuberculosis, and Malaria. European countries represent almost half of the Global Fund replenishment, and he hopes that the EU can use their significant influence to highlight the need to increase investments in existing pandemics, and to prepare us for future threats.

Finally, the discussion centered on how the EU is addressing TB and providing solutions. Lisa Goerlitz from Deutsche Stiftung Weltbevölkerung (DSW) urged member states to support EDCTP3, which will be more successful with more investments. Hannu Laang (DG Research and Innovation, European Commission) elaborated further, explaining that Horizon Europe, EDCTP3, and the Innovative Health Initiative Joint Undertaking (IHI) are important partnerships for TB funding, signaling both optimism that TB could have a high place on the EU health agenda, and the need for continuous collaborative research and investment. 

Following this event, we now call Members of the European Parliament to:

  1. Call for widespread support for EU-led Research and Investment programmes, such as Horizon Europe, EU4Health, EDCTP 3, and IMI, and encourage TB to remain high on the agenda;
  2. Commit to press governments and relevant multilateral agencies to promote and ensure global access to medicines, vaccines, medical equipment, and Research & Investment needed to face not only COVID-19 but also TB and other infectious diseases;
  3. Reaffirm commitment to the targets agreed in the Political Declaration from the UN High-Level Meeting on TB as now, more than ever, we need to strengthen international ties and work together in order to ensure a holistic, financed, sustainable, and accountable response to TB.
  4. As a member of the G20, commit to enhance efforts and funding for TB R&D and accelerate the scale-up of new shorter regimens of TB. More robust resources for TB R&D should be a central activity within the AMR agenda in order to address the challenges of developing new tools whilst delivering on previous commitments from the G20 and the UN HLM on TB, AMR, and UHC where the latter ones can never be successful without success in achieving the TB goals.
  5. Commit to sustained support for the Global Fund to fight AIDS, TB, and Malaria, the largest multilateral provider of grants for health and a key player in mitigating the impact of COVID-19 on progress made against other infectious diseases and on fragile health systems, as well as a leading organisation in the ACT-Accelerator global coalition.

You can watch a video recording of the event here (only available in English) 

Written by Lucy Foster, Western Europe Coordinator at the Global TB Caucus.

 

 

TB burden on women