Renewing the Fight Against TB and AIDS The opportunity in our lifetime Stop TB Partnership 22 nd July, 2014 | AIDS 2014 presentation | Melbourne, Australia

4.4 MILLION Two Epidemics, One Fight, …One Disease? TB and HIV - One Disease?

Save One Million Lives – Launched in 2011 by UNAIDS, WHO, Stop TB Testing for HIV and TB should be provided every three years in places where both diseases are prevalent. Prompt TB treatment needs to be provided to every person living with HIV with active TB - or else treatment to prevent TB. HIV and TB treatment must be accessible and of good quality so that people living with HIV are cured of TB. ART should be started early since people living with HIV are far less likely to become ill with and die of TB if they begin ART before their immune systems begin serious decline

TB-HIV The Numbers New HIV Positive TB Cases in m Of PLWHA screened for TB in % People with TB Tested for HIV in %

targetglobal 10 / 100k / 100k year TB incidence the burden

1.3 MILLION 8.6 MILLION estimated TB cases 5.7 MILLION new cases diagnosed and treated MDR-TB 450,000 estimated new cases the burden 77,000 MDR-TB cases diagnosed and on treatment XDR 45, 000 （ 10% ） estimated cases of XDR

we must act now to end TB in our lifetimes

the road to 10 / 100,000 TB incidence Scale-up to 100% coverage of proven interventions Prioritized focus on vulnerable groups- including women and children Integration within country-region context and system New tools today

What it takes Good, reliable data with a focus on key affected groups and vulnerable Know your epidemics and hot spots Walk away from everything everywhere and "vertical approaches" Prioritize and invest strategically Involvement and engagement of all stakeholders throughout the entire processes. Work in partnership

What we struggle with Need for bold and ambitious targets based on data but pushing boundaries Walk away from passive approaches and go towards active and patient/people centered work Need for scale up plans – no more "pilot projects" Work to fit in the overall country health system and plans Integrated approaches with efficiency savings

What we need more of Science of Delivery on the Ground – Know How Civil Society, communities and country based activists for TB Increased funding for high-impact programs and R&D Evolving global one size fits all approaches to more regional and country focused solutions

Discussi on  What are the barriers to better integration of the TB-HIV response – technical barriers, global and local advocacy, integrated delivery and testing?  What are the barriers to accelerated scale up of testing and treatment?  What else do we need more of? What are some of the challenges you face in your work?

Which came first?

WHO Post 2015 Strategy Goal: End the global tuberculosis epidemic 2035 Milstones: 95% reduction in tuberculosis deaths (2015 baseline) 90% reduction in tuberculosis incidence rate (2015 baseline) No affected families facing catastrophic costs due to tuberculosis

Rhetoric to Action: The Global Plan for TB First Global Plan to Stop TB: A ten-year Global Plan: year Global Plan: The next 5-year Global Plan: Global Plan for Global Plan for

Compon ents of the Plan Part 1: Implementation –DOTS expansion and enhancement –Drug-resistant TB –TB/HIV –Laboratory strengthening Part 2: Research and Development –Fundamental research –New diagnostics –New drugs –New vaccines –Operational Research

The Challenge Projections to 2035 compared with current trends

The Purpose The Global Plan to Stop TB 2016 – 2020 will: Show what it takes to set the world on the right track to reach the goals set in the WHO post-2015 Global TB Strategy It will describe the activities needed in different regions of the world in order to “bend the curve” of TB incidence and mortality It will provide an estimate of costs

Timeline Mar. ‘14 Start Q3-Q4 ‘14 Modelling, Country Missions & Regional Consultations Early-’15 Community/CS & Stakeholder Consultation Mid-’15 Draft for inviting comments on the web Sept. ‘15 Endorsement by the Stop TB Board Oct. ‘15 Launch

Discussi on  What should our country, regional, and global priorities be in the Global Plan for TB?  How can the next Global Plan incentivize TB-HIV integration?

Whydoes TBneedan identity?

22 Identity is not a… Logo Slogan Campaign But a lens for how we… Think Act Communicate

Weneeda paradigmshiftin the way wethink andspeakabout TB. 23 Stakeholder interview

Thisisnot arebranding exercise.It’s about creatingamovement thatchangesattitudes and behaviours. Stakeholder interview

6 From

7 ToTo

ProjectTimeline Feb 27 MarAprMayJuneJulyAugSeptOctNov Phase 1: Discovery + Analysis Phase 2: Strategic Platform Phase 3: Messaging Guidelines Phase 4: Visual Identity Phase 5: Validation Research Phase 6: Guidelines Phase 7: Implementation

Weneedtomake TBeveryone’s problem. Stakeholder interview 28

Thereneedstobea willingnessto accepttheway we’ve beendoing things[around messaging] hasn’tworked. Stakeholder interview 29

advocate or donor “XDR-TB” 30 TBisn’tspeakingtothe everydayperson Language and terminology is very clinical Doesn’t feel accessible to the average person Stigmatises people living with TB Doesn’t motivate the “incidence” “prevalence” “cases” “suspects” “detection” “default” “MDR-TB”

TBhasbeenhere forever and it hasn’tchanged. It’stimetomake itfitforthe21 st century. Stakeholder interview 31

Weneedtomakeit unacceptablethat peoplearedyingofTB. Peopleshouldbe outragedbythefact wehaveadisease thatiscurable. Stakeholder interviews 32

In the political sphere people want a practical, positive way forward. TB needs to feel like it’s a winning race. Politicians want to be associated with a cause that works. Policy Maker interviews 33

Theinsights 1.TB is trapped in the medical world 2.A scientific approach doesn’t engage hearts and minds 3.Complacency within the TB community is stifling progress 4.TB as a global issue is remote and lacks urgency 5.TB has played the unconfident underdog for too long

Theopportunities 1.Position TB as a social issue 2.Create a human connection 3.Be entrepreneurial with TB 4.Make impact personal 5.Tell a hopeful + heroic story

The identity of TB must capture two core thoughts… ProximityHumanity

Closer The concept: Disclaimer This is not finalised – we are sharing it as an initial concept for discussion TB is closer than we think. The solution is closer than we imagine. The fight is more urgent than ever before. Get closer to TB.

Intimacy: an emotional connection that makes TB real and personal Unity: understanding that TB is everyone’s problem to solve Empowerment: unleashing latent power in others to beat TB Progress: fighting stigma, raising awareness and creating results The principles:

Confront stigma by getting closer together and talking about TB’s truth Create urgency by demonstrating the need for global, collective action Activate support by empowering each other with the tools and inspiration Push for progress by working closer together to create change where it matters The asks:

TB is closer than we think. Getting closer to the reality of TB, the survivors and supporters, brings you harsh truth; a deplorable kind of injustice. Uniting our collective strength gets us closer to resolution. We can confront stigma, create urgency, activate support and push for progress. With advocacy, perseverance and passion we can get closer to reaching the 3 million that need treatment, closer to stronger communities and closer to life that goes on living. Get closer to what TB is. Humanity's problem to solve. For our children. For our future. For all of us. We deserve to live without fear. Get closer to a world free of TB. The story :

Options for the visual identity are being prepared, and di ff erent ideas will be tested across the global health community. Only after a wide consultation will the identity be ready to be launched into the world. VisualIdentity

of TB The world is becom‹iJg smaller and we are closer to each other than ever before. Explore the truth of TB. 18 OCTOBER - 20 DECEMBER 2014 FREE FOR MEMBERS

The real stories of TB Survivors. Don't let barriers stand in your way. Get closer to the truth. Get closer to what TB means, how it works and how to fight back. Showing of 1221 stories Getting the support I needed to beat TB Protect yourself from TB Dangers of TB in school Living with latent TB Most recent

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Skype stories

Thankyou.

Discussion What was your initial reaction? What works? What could be better? Would the TB Community unite behind it? 81