By John Lechleiter
While visiting the Fort Grey Hospital in East London, South Africa, several of my Lilly colleagues recently spoke with a brave young woman named Phumla as she was undergoing treatment for drug-resistant TB. She contracted the deadly disease from her sister, who had passed away just a few days prior. Phumla was devastated, but she refused to give up hope. “I want to be cured. I want to go home,” she said. Her resolve was deeply moving and underscored the urgency of the fight against drug-resistant TB.
Sadly, Phumla’s story is becoming more common as new cases of deadly drug-resistant TB are reported – and not only in the developing world. Earlier this year, one of the most severe cases of drug-resistant TB in U.S. history emerged in Texas. The World Health Organization projects that as many as two million people may develop drug-resistant strains of TB worldwide by 2015 – despite everyone’s efforts to achieve the 2015 Millennium Development Goals related to TB. The fact is, every time we fail to treat TB completely – everywhere we find it – drug resistance can take hold, dramatically increasing the threat to patient health and the cost of controlling the disease.
Neither governments nor market forces alone can solve this urgent global health problem, but working together in partnership, progress is indeed possible. Strong investments today – starting with the Global Fund to Fight AIDS, Tuberculosis and Malaria – will diminish the threat posed by drug-resistant TB, and enable us to stop the scourge of all three of these diseases.
The Global Fund’s powerful impact
Around the turn of the century, HIV/AIDS, TB and malaria killed more than six million people each year. Virtually no one in low- and middle-income countries had access to the life-saving antiretroviral therapies that have proven effective in treating HIV. Public health budgets for TB and malaria control were practically non-existent. The Global Fund was founded in 2002 to change all that. This public-private partnership set out to dramatically increase the resources available to control these diseases by moving them to the top of the world’s agenda.
Few organizations have had such a tremendous impact in such a short time. To date, the Global Fund has raised and committed more than $23 billion dollars in more than 150 countries. And it has set the standard for development financing by operating in a transparent, demand-driven, and results-oriented way, with robust monitoring and evaluation.
As of December 2012, with financing from the Global Fund:
-9.7 million cases of TB have been detected and treated;
-4.2 million people are receiving antiretroviral therapies – nearly half of the total patients now on treatment in low- and middle-income countries; and
-310 million mosquito nets and 181 million cutting-edge anti-malarial treatments have been distributed.
These efforts have helped effectively change the trajectory of HIV/AIDS, TB and malaria, capping – and now shrinking – the total number of cases worldwide for each of the diseases.
The Global Fund just announced its fourth major fundraising effort, targeting $15 billion over the next three years to satisfy proposals and projections from Ministries of Health and technical partners in disease-burdened countries around the world. That level of funding would pave the way to covering up to 85 percent of people in need with key interventions, and save as many as 5.8 million lives through access to treatment alone. It is absolutely critical to ensure that the Global Fund is fully funded in order to prevent drug resistance from undermining the gains we’ve made against TB, and to keep us on track to get all three of these diseases under control. Taking our eye off the ball now would imperil future generations and result in significantly higher health care costs for governments around the world.
Public-Private Partnerships a key to progress
Even with full funding, the Global Fund can’t tackle these diseases alone – and fortunately it won’t have to. A wave of public-partnerships have been launched since the UN established the Millennium Development Goals in 2000, creating specific targets for improving social and economic conditions in the world’s poorest countries by 2015. A special focus was placed on controlling HIV/AIDS, TB and malaria, and the response has been historic.
Today, the pharmaceutical industry is engaged in 40 partnerships targeting TB – including the Lilly MDR-TB Partnership, which is focused on training healthcare professionals to identify and treat drug-resistant TB, and increasing access to quality assured second-line TB drugs. Ground-breaking open-source research initiatives like the TB Drug Accelerator Program, funded by the Gates Foundation, could soon yield more effective, faster-acting TB treatments, which we urgently need to outflank resistant strains of the disease. Another 43 public-partnerships target HIV/AIDS, and 37 more focus on malaria.
These initiatives are fueling collaboration at all levels, from R&D to testing, treatment and prevention. Indeed, many of them are working in conjunction with the Global Fund to fight against diseases of poverty in diverse ways that create value, efficiency and results.
Her story reminds us that pressing public health challenges demand our collective best. We must fully fund the Global Fund, find new and better treatments, and seek creative solutions through innovative public-private partnerships. Together, we can stop drug-resistant TB – and even see the end of AIDS, TB and malaria once and for all.