Dignitaries, Partners, Colleagues and Friends
A very good morning to you all.
I regret that I am not able to be with you today but thank you for inviting me to address you at this Global Forum on Advancing Multisectoral and Multistakeholder Engagement and Accountability to End TB.
Tuberculosis is more than a biomedical disease, and multisectoral engagement and accountability has been recognized as a key strategy for ending TB.
To this effect, the UN High-Level Meeting on TB in September 2018 along with Commitments for enhanced coverage, requested the Director General of WHO to develop the Multisectoral Accountability Framework on TB (MAF-TB).
Accordingly, WHO Global TB Programme (GTB) developed the MAF-TB framework that was endorsed by Member States at the World Health Assembly in May 2019.
Our WHO South-East Asia Region bears a significant burden of TB. In 2022, we accounted for 45% of the global new TB cases, and over half of the related deaths.
Moreover, nearly 40% of rifampicin-resistant and multi-drug resistant TB emerged in our region. Around 20% of new TB cases in this region are linked to undernutrition, in addition to the association with poor living and working conditions. TB control goes beyond the healthcare system. It demands a multisectoral approach, with robust political will and collaboration to establish an effective accountability framework.
According to the WHO GTB Report 2023, globally there is a decline of only 8.7% in TB incidence rate, and 19% decline in deaths due to TB against the baseline of 2015. In our Region, the incidence declined only 6.6% and mortality by 6.3% respectively. 42% of our people still face financial hardship due to TB, against the target of zero. This is too slow to reach the UN SDGs/End TB targets by 2030.
Our WHO South-East Asia Regional Strategic Plan towards ending TB 2021-2025 includes interventions within and beyond health systems, for a comprehensive approach towards ending TB. Multisectoral engagement, as envisaged in the strategy, aim to address social determinants of the disease. They also aim to address the needs of vulnerable and marginalized populations through strong community engagement.
Our Region has undertaken some commendable work in implementing the MAF-TB framework. Ten of our eleven countries published annual TB reports. Ten countries also have multisectoral and multistakeholder accountability and review mechanisms, and 6 countries engage civil society and affected communities through multisectoral mechanisms.
In Bangladesh, MAF-TB baseline assessment was completed, and an action plan for MAF-TB was developed in 2021. MAF-TB implementation was assessed during the joint Programme review in 2022. The Strategic Operational Plan for MAF-TB prioritized 10 Ministries, and the Bangladesh Country Coordinating Mechanism established the Financial and Sustainability Committee to ensure domestic funding for TB.
Since 2017, our region has demonstrated strong political commitment towards ending TB through various high-level ministerial meetings. The most recent one, in August 2023, led to the “Gandhinagar Declaration.”
The Gandhinagar Declaration advocated for establishing multisectoral coordination mechanisms that report to the highest political level for monitoring progress toward ending TB and other communicable diseases. It also called for leveraging science and technology to ensure equitable and rights-based access, through an integrated primary healthcare approach. And, notably, it advocated for allocating the necessary resources to meet TB service coverage targets, to address social determinants, to achieve universal health coverage goals, and to enhance pandemic preparedness.
The UNHLM’s political declaration in September 2023 reinforced the commitment to multisectoral engagement, outlining specific responsibilities for various sectors and stakeholders and emphasizing the importance of community engagement.
UNHLM 2023 sets ambitious targets for coverage, in alignment with the WHO DG’s flagship initiative, that countries have committed to achieving by 2027.
This Global Forum here today presents an opportunity for Member States, partners, civil society, and key stakeholders to engage in dialogue, strengthen MAF-TB, and coordinate efforts across sectors to combat TB effectively.
I trust this forum will come out with specific recommendations, keeping in mind the UNHLM 2023 commitments and End TB milestones:-
- Find a way to establish and speed up the high-level multisectoral accountability mechanisms reporting to the highest political levels in each country.
- Address social determinants of TB, and the associated comorbidities, including mental health through a multisectoral approach.
- Reach out to the most marginalized and vulnerable groups, including women and children leaving no one behind, with meaningful community engagement.
- Promote research and innovation through South-South collaboration, share experiences and have a multi-country approach towards ending TB.
In conclusion, I reaffirm WHO’s commitment to support Member States in achieving the ambitious goals of ending TB. Thank you for your participation in this worthy and worthwhile mission.
I wish you a fruitful meeting and eagerly await the outcomes of your deliberations.