Remarks by Dr Matshidiso Moeti, WHO Regional Director for Africa at the first WHO Global Ministerial Conference: Ending TB in the Sustainable Development Era Congress Hall, WTC, Moscow, November 2017

Submitted by elombatd on Thu, 23/11/2017 - 17:18

Honorable ministers,

Fellow UN agency leaders and heads of regional bodies,

Dear partners in NGOs, academia, philanthropic foundations and the private sector,

Ladies and gentlemen,

I am very proud to report that the African Region has shown significant progress in combatting TB in many countries, as a result of effective, available interventions when applied correctly and widely.

We achieved the MDG targets, and countries are experiencing significant declines in TB notifications, incidence and deaths.

For the first time in decades, new TB diagnostic tools and treatments are being applied with superior outcomes, even in limited resource settings.

The Global Fund, other donor partners and technical agencies have invested substantially to fund and provide technical expertise in Member States to scale up effective interventions.

Never before has the goal of ending the TB epidemic in the African Region by 2030 seemed more achievable: we have an approach which actively involves all stakeholders; we have the tools; and we have growing political will.

But we will need significant country commitment to address the challenges that lie in our way.

With 16 of the 30 global TB High Burden countries in the African Region, the current rate of decline of TB incidence lags far behind the level needed to end the epidemic by 2030.

We are missing large numbers of TB cases at facility and community levels due to sub-optimal policy directions, inadequate coverage with primary health services and inadequate collaboration with the private sector, among others.

TB/HIV co-infection rates are still unacceptably high. Despite massive escalation of the ARV programme in some countries, PLHIV without access to ART remain extremely vulnerable.

Drug resistant TB is ringing all the alarm bells of a global public health crisis, and is rising in the African Region in the face of inadequate national responses to this growing concern.

Domestic financing of TB control interventions is mostly not commensurate with the disease burden (if it is available at all), even for core commodities such as first line anti-TB medicines, let alone for new diagnostic technologies and treatments. This threatens to reverse all the gains we have made.

Ladies and gentlemen, despite these challenges – which must be addressed – there is hope for health in Africa.

More than 20 countries in sub-Saharan Africa have achieved middle income status, and projections by the Regional UN Development Group are that over the next decade, most countries on the continent will be considered middle income.

This is a testimony to Africa’s rapid transformation, characterized by remarkable economic growth and strong development progress.

This momentum means countries will need to be innovative in how they raise domestic resources for basic health services once they graduate to middle income status and become ineligible for donor aid.

This will require strong partnerships, focused on country priorities, and a move to people-centred health systems, with increased engagement of communities and civil society.

Expanding Universal Health Coverage as a catalyst to reach our End TB goal will mean developing and rolling out social protection schemes that will buffer vulnerable populations and promote access to TB services.

Ladies and gentlemen, it is critical that each country here adopt bold, time bound strategies and frameworks that will accelerate national performances towards the SDG and End TB Strategy targets, as endorsed by Heads of State and government and the World Health Assembly.

Most importantly, this will include:

Adequately and sustainably financing such implementation, ideally from domestic sources.

Aggressively scaling up high impact interventions for susceptible and drug resistant TB; and expanding modern TB and related diagnostic, treatment and care services.

Addressing the root causes of TB - the social and other determinants of TB infection and disease, and funding research to promote evidence-based policies.

As Regional Director, I am determined to do everything I can towards ending TB in the African Region by 2030.

I am committed to accelerating and supporting efforts of all the Member States in the African Region to realize this result and galvanizing support for strong participation in the UNGA high level meeting on TB next year.