47th Union World Conference on Lung Health: WHO preconference meeting sizes up the challenges, imagines a world without TB

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Science Speaks is in Liverpool this week covering developments and impacts in global tuberculosis research, programming and funding.

Science Speaks is in Liverpool this week covering developments and impacts in global tuberculosis research, programming and funding.

As a fab 47th Union World Conference on Lung Health comes to Liverpool, session titles and speakers nod to city’s favorite sons, while focus of WHO symposium is global and forward . . .

LIVERPOOL, England – Around the last time a new and widely accessible treatment for tuberculosis was being readied for market, the Beatles were making their name at the Cavern Club in this city that has celebrated their success ever since.

While the Beatles moved on to legendary renown and acclaim, tuberculosis receded into memory — for a time. After all, back then, affluent countries all over the world had beaten the disease into obscurity. Now, as speakers throughout a preconference event today noted, tuberculosis that does not respond to the first lines of treatment has been found in every country where it was looked for, and among people who have those drug-resistant strains of disease, treatment that was given was successful among just 52 percent of patients. A disease that has been curable since the middle of the last century today kills a person every 18 seconds — with recently improved data showing that 1.8 million people lost their lives to tuberculosis in 2016.

No wonder an air of nostalgia permeates the schedule of this conference now, with titles of presentations this week tackling drug resistance, lack of donor funding, and failures in patient care  that include “We Can Work it Out,” “Here, there, and Everywhere,” and “The Long and Winding Road,” as well as at least two poster sessions with titles beginning with “Help!

In the meantime, in a tradition begun in 2011, when the World Health Organization launched an event preceding the conference with a day-long current look at global tuberculosis, a series of sessions today looked forward to spell out tolls, costs, responses, and demands of tuberculosis worldwide, and what needs to change to make the promises of the past meaningful.

It began with tribute to two champions who both, in lives cut short, devoted substantive careers all the same to saving the lives otherwise claimed by the preventable, treatable, curable disease of tuberculosis. Jon Voskens, who worked on tuberculosis control for more than a quarter of a century, didn’t write a lot of papers, his colleague from KNVC Tuberculosis Foundation said, while his work in Indonesia focused on the patient. He died of Japanese encephalitis, she said, “a great man, killed by a tiny mosquito.” Stephen Lawn, who died last month of brain cancer, was passionate about his scientific advocacy for people living with HIV and tuberculosis, his colleague from the London School of Hygiene and Tropical Medicine said, and influenced his field with work that continues now in the ongoing STAMP trial to determine the benefits of screening HIV hospital patients for TB with a urine-based test.

The day then focused on the future, in the shape of a new era of goals under the Sustainable Development agenda, that count tuberculosis twice among their targets — to be virtually eliminated by 2030, and for its treatment during the interim to become universally accessible, and in milestones set by a global strategy to reduce the toll of tuberculosis by 95 percent by 2035 — basically reconcilable aims.

But they come at a time when the last WHO global tuberculosis report, reviewed here today, show higher TB incidence and mortality than previously pegged, while funding, always short of projected needs, continues to fall far short of projected need, including, as a Treatment Action Group report released today, to its lowest level for research and development in seven years.

And for all the incremental progress made in areas that include political will, in an update on the global Parliamentary Caucus launched two years ago at this conference in Barcelona, and civil society input, formalized in a task force also formed two years ago, progress in research and development  — for new tuberculosis diagnostic technologies, medicines, regimens, and a vaccine, continues to be be promising, but stalled by lack of funding speakers across the afternoon reiterated. From the Bill and Melinda Gates Foundation, Cathy Bansback asked audience members to Imagine a treatment that is short, safe and effective. “Some may say I’m a dreamer,” she added, “but I’m not alone.”

We will follow all of these as the conference begins Wednesday. Until then, some thoughts from WHO Global Tuberculosis leader Mario Raviglione as he wrapped up the session today:

And in the end . . .

And in the end . . .

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