A plea from civil societies in India on behalf of the millions affected by TB
Do not withdraw your support to saving lives
The Global Fund to Fight AIDS, Tuberculosis and Malaria has been a key partner in the world’s fight against TB, a killer disease that continues to take millions of lives despite being curable. In India, this is especially true. India bears the highest burden of TB, with over a fifth of the cases globally, and faces the disasters of drug-resistant TB and TB-HIV co-infection that could claim many more lives. The 2011 report of India’s National TB Programme points to more new TB cases added here each year (two million in 2009) than in any other country. But, equally, Global Fund support has made a vital difference. It has helped give people a voice and strengthened their very necessary role in spreading awareness and access to complete treatment to combat a disease that thrives on poverty, ignorance and stigma.
The recent decision by donors to cut contributions to The Global
Fund is alarming. The war against TB has been extremely hard for
all of us. If funding stalls at this stage, it can reverse the
gains so far and translate into millions of lives lost. Please
do not let this happen. It will be a human tragedy not fit for a
civilized world.
While we recognise that recent economic developments have forced
donors to curtail global development funding, there are
exceptionally strong reasons why funding for TB control in India
must not fail at this critical juncture:
-- India itself explains why TB continues to be a major scourge
here and why all must jointly combat it. Despite its emerging
global stature, it is unimaginably populous, crowded and
unequal, with the majority living in abject poverty, without
basic health care or social support. It has large migrant,
tribal, remote and slum populations that are vulnerable to
infectious diseases like TB. Many lack knowledge of TB, suffer
from stigma, and go to untrained private practitioners. Health
systems are weak, incomplete treatment common, and
drug-resistant TB very real. The context calls for an
uninterrupted and coordinated effort across sectors.
-- Civil society is currently giving one of the strongest
pushes, in global history, to TB control, with support from
partners like The Global Fund, and in coordination with the
government. Without this support, the movement would die as
there is no other funding mechanism in the country for the task
at hand. Years of progress will be stalled, and indeed reversed,
with the poor and the marginalised bearing the brunt of it. It
will be a major setback to goals like ‘universal
access’, to community motivation, and to the money already
spent, just as real headway was being made.
-- Global Fund Round 9 TB funds to India started a landmark
five-year civil society project in 2010 on ‘Advocacy,
Communication and Social Mobilisation’, with an ambitious
target of reaching some 750 million people in 374 districts
across 23 states, including 174 million women, 199 million
children and 250 million people in poor districts. Phase I,
2010-12, has shown encouraging results, with 247593 patients put
on treatment in the second quarter in 2011. Phase 2, 2012-15,
will now be critical.
-- Stability of funding is crucial to not stifle newly emerging
grassroots voices that have now begun to mainstream patient and
community needs in India. Restricting support at this stage will
signal a broader retreat from partnerships in governance, push
back rights-based health reforms, and halt the on-going process
of community empowerment in TB care and control. The Global Fund
has helped India customise its TB programme through social
participation in public health, and made access to healthcare
more democratic. We must not lose the opportunity to replicate
this model.
-- India is at a point when the national momentum can have a
global impact on the Millenium Development Goal of halving the
rate of TB infections by 2015. While India is increasing its
health spending in its next five-year plan, this remains below
the World Health Organization standard. With economic slowdown
and competing priorities, there are major challenges to
consistent health spending by emerging nations like India. Donor
funds can be oxygen in this time.
The Executive Secretary of the WHO Stop TB Partnership recently
said “Let us not squander the huge investment the world
has made in the health of people living with HIV by losing them
to TB, a curable illness.” What was said in the context of
TB-HIV co-infection globally bears a great parallel to
‘The huge investment’ civil society has made in
India.
We cannot squander this investment away.
The Global Fund is a crucial partner now in India’s fight
against TB. Beyond the logic of reasons for why this fight must
go on, and why it needs support, there are bigger questions too:
of ethics, of commitment, of solidarity and, indeed, of human
life itself. It is our appeal and request that these questions
are not forgotten.
Partnership for TB Care and Control India
