INT J TUBERC LUNG DIS 22(12):1387
Q 2018 The Union
http://dx.doi.org/10.5588/ijtld.18.0702
A new era for global tuberculosis: holding leaders accountable
for promises
SEPTEMBER’S UNITED NATIONS (UN) General
Assembly was a historic moment for tuberculosis
(TB). For the first time ever, the UN convened heads
of state and government at a High-Level Meeting on
the fight against TB, which produced a UN political
declaration on TB.1 Political commitment, with
adequate resources, is essential to achieving the End
TB Strategy.2 The world now has a global TB political
framework endorsed at the highest levels of govern-
ment that includes targets to achieve by 2022—a
timeframe relevant for currently serving national
leaders.
Among other promises, leaders committed to:
 successfully treat 40 million people for TB, includ-
ing 3.5 million children and 1.5 million people with
drug-resistant TB
 provide TB preventive therapy to 30 million people,
including 4 million children under the age of 5
 include child TB in the child survival agenda and
provide family-based TB care
 advance all areas of innovation, including support-
ing the Life Prize (http://www.thelifeprize.org/) and
the BRICS (Brazil, Russia, India, China, South
Africa) TB Research Network, needed to deliver
new tools for TB prevention, diagnosis and
treatment
 support a human rights-based approach to global
TB
 mobilize US$13 billion annually for TB care, and
US$2 billion annually for TB research and devel-
opment.
The greatest drawback of the political declaration
is that it created no independent mechanism for
holding leaders accountable for success or for
contributing the necessary resources. To hold leaders
accountable, we suggest that the TB community take
the following collective actions:
Launch an advocacy campaign through 2022 that
advocates for progress toward national-level targets
derived from the declaration’s global targets. The
campaign should involve direct political engagement,
media relations, smart use of data and compelling
storytelling. The growing advocacy networks of TB
survivors—including TB People, We Are TB, and TB
Proof—should be at the forefront of the advocacy and
nurtured until they include engaged survivors in every
country.
Engage new partners. The World Health Organiza-
tion’s 2018 Global tuberculosis report shows that
undernourishment, human immunodeficiency virus,
EDITORIAL
smoking tobacco, diabetes, and the harmful use of
alcohol are underlying factors in half of TB incidence.3
We need to make common cause with these commu-
nities.
Elevate TB prevention as an advocacy priority,
starting with rapid, routine screening of household
contacts. Only one in four household contacts under
five were screened for TB in 2017, and only half of
high TB-HIV burden countries are even reporting
data on household contacts with HIV who received
preventive therapy last year.
Rebrand World TB Day by declaring March TB
Prevention Month. Doing so will create more time
and opportunities for advocacy and community
engagement. Heads of state and government have
the most visible platforms in their countries. They
also have numerous responsibilities. TB Prevention
Month will provide more time for local and national
campaigns, community engagement, and participa-
tion with heads of state who have just committed to
achieving historic gains against TB.
After the UN High-Level Meeting on TB, the global
TB community faces an unprecedented opportunity
to mobilize political and social action against TB. We
must seize it together.
JEREMIAH CHAKAYA
JOSÉ LUIS CASTRO
PAUL M. JENSEN
PAULA I. FUJIWARA
International Union Against Tuberculosis
and Lung Disease
Paris, France
e-mail: pjensen@theunion.org
Conflicts of interest: none declared.
References
1 United Nations. Political Declaration on the Fight against
Tuberculosis. Co-Facilitators’ revised text, 11 September 2018.
New York, NY, USA: UN, 2018. https://www.un.org/pga/72/wp-
content/uploads/sites/51/2018/09/Co-facilitators-Revised-text-
Political-Declaraion-on-the-Fight-against-Tuberculosis.pdf Ac-
cessed October 2018.
2 World Health Organization. Global strategy and targets for
tuberculosis prevention, care and control after 2015. EB134/12.
Geneva, Switzerland: WHO, 2013. http://apps.who.int/gb/
ebwha/pdf_files/EB134/B134_12-en.pdf?ua¼1 Accessed October
2018.
3 World Health Organization. Global tuberculosis report, 2018.
WHO/CDS/TB/2018.20. Geneva, Switzerland: WHO, 2018.
http://apps.who.int/iris/bitstream/handle/10665/274453/
9789241565646-eng.pdf?ua¼1 Accessed October 2018.