Stepping up to the plate29/03/16
Fanny Voitzwinkler, Head of EU Office, Global Health Advocates, argues how the world needs strong European Union leadership in the fight against tuberculosis
Every year in Europe, 340,000 people become sick with tuberculosis. In 2014, 33,000 people died from the disease: this is 33,000 too many. Outdated or ineffective treatment methods, together with a lack of financial and political will, are still making tuberculosis a painful reality for millions across the world as well as in Europe.
Countries from Eastern Europe and Central Asia are among the hardest hit by multi-drug resistant tuberculosis (MDR-TB), a form of the disease particularly difficult and expensive to treat. The economic burden that TB causes in the region is also significant. MDR-TB treatment in the EU costs around five to eight times more than treatment for standard TB. It is conservatively estimated that the economic cost of TB in the EU amounts to €5.9bn per year.
To compound this alarming situation, the economies in Eastern Europe and Central Asia are growing and donors are withdrawing their support, shifting their focus to lower-income countries. Yet external funding for TB and HIV services is critical in the region. The progress made so far in tuberculosis and HIV responses is dangerously at risk if national governments don’t step up to the plate, providing domestic resources to fill in the funding gap in their health systems.
The region is home to the fastest growing HIV epidemic and the highest rates of MDR-TB in the world, with the diseases disproportionately affecting key populations. Civil society is central to the TB/HIV response, often being the only players able to reach and ensure access to medical and social services for people in need. Yet, it is these critical services that are most at risk as international donors withdraw and domestic financing is slow to appear.
For example, in Romania, USAID stopped TB programmes and Global Fund’s support to HIV prevention programmes ended in 2007 and 2011 respectively. As a result, the country saw the number of new HIV infections double from 2009 to 2012, unravelling the progress made.
There is an urgent need of planning sustainable transition in Eastern Europe and Central Asia, ensuring that programmes to fight tuberculosis and HIV will be effectively continued and scaled up after the withdrawal of international donors, with national governments taking the responsibility for funding these programmes with domestic resources.
For a successful transition, donors, civil society, technical agencies and governments need to work together, sharing responsibilities to find effective solutions.
The European Union and other donors like DFID in the UK need to realise that abrupt withdrawal of support to middle income countries will have negative impacts on the regions affected. The logical response is a concrete political strategy to ensure sustainability of aid. This is even more relevant considering that the tuberculosis epidemic in Eastern Europe and Central Asia represents a cross-border threat.
The EU, as a strong political actor in the region, can definitely play a key convenor role in this process. An EU transition focal point across European Commission services would be an important first step in ensuring dialogue to identify political solutions and ensure sustainability of TB/HIV services.
The multiple challenges Europe is currently facing are no excuse for postponing action until this issue fits the agenda. We hence call on the European Commission to convene a partnership meeting by the end of this year, bringing together all stakeholders to discuss and agree on concrete roadmaps for a successful transition to domestic funding.