“We need to raise our voices again” — Nick calls for new action to End TB

As Chairman of the Global TB CAUCUS Nick spoke at the Official Closing Ceremony of the 51st Union World Conference on Lung Health which was livestreamed on 24 October 2020. This speech was delivered ex tempore, without notes.

Hi, it's a great pleasure to be able to join you at the end of your conference. I'm only sorry that it hasn't been possible for us to meet in person. Let's hope that we'll be able to meet physically at future conferences. 

Six years ago, I addressed your conference in Barcelona. A few members of parliament attended. We decided to set up the Global TB Caucus because we knew that TB needed a stronger political voice. Since then the Caucus has grown hugely. We're now number 2,500 in 130 countries, and we’ve set up 43 new National TB Caucuses, most recently in Pakistan, where there were very few before, ensuring that TB has a voice in the parliaments around the world.

We've spoken up and organised of course, in our own countries, but also together we've taken action to get TB onto the G7 agenda, the G20 agenda, and of course at the UN High Level Meeting in New York.

I think there's one person who deserves much more public credit for the launch of the Caucus and for what has been achieved, and that's Jose Castro. Right from the beginning, he was the Caucus’ strongest supporter. He enabled it to happen by hosting our first meeting at your conference. He continued to ensure that the Union gave the Caucus its full support. It was very much emblematic, I think, of Jose’s, tremendous leadership in the world of TB.

I will always be immensely grateful to him for what he did for the Caucus, but also for the fight against TB generally. We'll miss him from the Union, but are delighted that he will continue to be engaged in these issues. And I look forward to continuing to work with him as I do with the Union.

It was with high hopes that we went to that High Level Meeting in New York two years ago.

The Declaration that was agreed was strong. It recommitted the world to action against tuberculosis. It set ambitious new treatment targets to ensure that we would get back on course to meet the Sustainable Development Goal, to beat the epidemic in 10 years’ time. But of course, COVID has intervened.

The truth is that actually, even if it hadn't, we would have still been off target; now we’re even more dramatically off target. In the words of Madhu Pai, if we had a mountain to climb before, it's just become Everest. I hardly need to tell you what every report has shown, that there has been a huge transfer of healthcare resource away from the existing epidemic, and of course, other diseases, towards the fight against COVID. And there's been a transfer of political attention too - COVID has seized the world's leaders, knowing that they have to deliver in the fight against this disease, which has frankly frightened and affected everybody.

And that position now has become one that is very serious for the existing diseases, which continue to exact a terrible death toll themselves. What then to do? Well, I just want to say two things. First of all, we have to speak up. We owe it to our communities to continue to take a stance, to use our voice, to ask that political leaders don't forget tuberculosis. We must do that. It's not enough and it's never been enough, to continue the fantastic work that everybody here does, as scientists, and doctors and researchers, and members of NGOs in their own organisations. We have to work together, and we have to speak up. 

We have to ensure that TB has a strong voice, and we have to work together to make that so, and the need has never been greater. So this is not a time to be silent or to be cowed, or to think that it's not possible for us to make the case for TB. Actually the need has only become more urgent. 

The second thing that I would say is that we don't have to present some kind of alternative between tackling COVID and dealing with TB. It's easy, of course, to see things in that binary way. But the truth is that global health security has now rocketed up the political agenda. Politicians weren't really talking about this before and they are now, they know that tackling infectious diseases is something that can't be ignored. They know the economic and humanitarian toll that can be exacted.

We were making the case that they should tackle TB in its own right and because of the risk of AMR; actually a new disease has come along, an airborne, infectious disease that affects the lungs, that can kill people. It was a different disease, but the battle against these diseases is one that has to be fought together. The solutions have to be found together. And in the future, what is it that we will need to ensure that we can achieve that global health security? Well, it will be better surveillance. It will be resilient healthcare systems. It will be universal healthcare coverage. It will be stronger primary healthcare. It will be better diagnostics and treatment ability. It will be stronger investment in R&D so that we have the tools to fight these diseases. 

So let's not see these things as alternatives. I know that it's hard not to at a time when resources have been switched away from TB, but in the end, the fact that COVID has arrived has only increased the salience of global health security in today's political discourse.

And that is, if it's possible to look on the bright side, one opportunity that arises from both terrible diseases that actually we can now grab political attention and ensure that these diseases are finally beaten. 

It's D minus 10: 10 years away from that sustainable development goal target, and we mustn't give up. We must continue to draw the attention of the world's political leaders to the need to beat a disease that still claims the lives of a million and a half people a year and will continue to do so. Unless we take further action, don't let’s believe that we are asking politicians to make a choice. We're asking them to focus on the need to ensure health security across the piece.

It's our responsibility to do that, as elected parliamentarians for the people we represent, and it's our collective responsibility, I would argue, to work together to ensure that this disease can be beaten. TB has always been the orphan disease. It feels even more of an orphan now. Well, we don't just ignore orphans: we do something about them. So this, six years on, is another call to arms. We need a new plan. We need to work together. We need to raise our voices again, and we need to ensure that TB is not forgotten and that we continue the fight against this disease. I look forward to continuing to work with the Union, with the Stop TB Partnership, with the WHO, with all the NGOs, and with all of you, to ensure that at last we can end TB.

 

 
SpeechesNick HerbertTB