Goa to Munich: Growing call for 100-100-100 to end TB and end AIDS before 2030

Shobha Shukla, Bobby Ramakant–CNS
Contd from previous issue
Vietnam, Zambia, Zimbabwe, Costa Rica, Ecuador, Pakistan, Japan, Rwanda, Indonesia, USA, Lesotho, and Thailand.
Tariro Kutadza, who leads TB People (Zimbabwe), said in AIDS 2024 Affiliated Independent Event on TB and HIV that Goa Declaration was launched by the delegates who participated in the “United against TB: Accelerated action towards achieving SDG on tuberculosis” meet held in Goa, India (15th – 17th May 2024). Since then, many more people from around the world have endorsed the Declaration on an ongoing basis.
Goa Declaration recognises that ending TB by 2030 is a public health and human rights imperative, as well as critical to advance progress on other UN Sustainable Development Goals (SDGs) and targets.
Tariro puts on spotlight the promises made by world leaders as part of the UN SDGs (to be met by 2030) and Political Declaration of UN General Assembly High Level Meeting on TB in 2023 (to be met by 2027).
Dr Samantha Tinsay, Municipal Health Officer, Bantayan Municipality, Cebu, Philippines shared few of the recommendations of Goa Declaration in AIDS 2024 Affiliated Independent Event on TB and HIV:
- Wider scale up of the pilots of introducing new tools project (iNTP) of Stop TB Partnership and USAID that have shown impact in terms of finding more TB cases and linking them to care in a time bound manner.
- Prioritising taking WHO recommended point-of-care TB screening and diagnostic tools to the people’s doorstep, over optimising existing centralised or semi-centralised or lab-dependent tools or models which often have access barriers, result in diagnostic delays, catastrophic costs, and drop out of people from the care cascade.
Catherine Murombedzi of TB People (Zimbabwe) and a noted health journalist shared the following recommendations of Goa Declaration in AIDS 2024 Affiliated Independent Event on TB and HIV:
- Effectively engaging communities in the response to TB at every level. TB survivors, affected communities, and community health workers bridge a deadly divide between existing services and most-at-risk populations.
- Community-led monitoring is another evidence-backed method to engage communities in TB programmes meaningfully as well as improve the service uptake from people’s point-of-view. We must listen to the people and communities we serve. Community leadership is also pivotal for demand generation for equitable access to the full range of TB services.
- Phasing out upfront use of microscopy completely and replacing it with WHO recommended molecular tests.
- Increasing TB testing for children with samples that do not depend on sputum only (for example, stool or other methods).
- Effectively integrating TB programmes with other health and development programmes, such as those on HIV, NCDs, HCV, harm reduction, nutrition, tobacco control, among others.
Tarit Chakraborty from TB People (India) shared the following recommendations of Goa Declaration in AIDS 2024 Affiliated Independent Event on TB and HIV:
- Screening everyone for TB regardless of symptoms in high burden settings. With an alarming number of TB prevalence surveys showing that a large number of people with TB are asymptomatic, it is imperative to find all people with TB early enough by deploying evidence-based tools like ultraportable x-rays for population-wide screening (regardless of symptoms) and confirming those with presumptive TB on molecular test upfront.
Linking all of them to care will help stop the infection-spread. Increasing use of mobile/ outreach clinics for population-based screening will help. Where appropriate, intensified TB screening of everyone (regardless of symptoms) should be done in private sector facilities too.
- Making same day 'test and treat' a reality for everyone with TB including Key and Vulnerable Populations.
- Optimally leveraging upon public private mix approaches to engage all healthcare providers in TB responses should be prioritised.
Dr Tin Maung Htwe, a senior journalist and editor from Myanmar shared the following recommendations of Goa Declaration in AIDS 2024 Affiliated Independent Event on TB and HIV:
- Ensuring that universal and upfront drug susceptibility testing (DST) is a reality for every person diagnosed with TB. Doing universal DST will also increase diagnosis of drug-resistant forms of TB, prevent the spread of drug-resistant strains, reduce human suffering and untimely deaths. It will also reduce diagnostic delays and catastrophic costs.
(To be contd)