PUTTING AN END TO TB WHERE ARE THE OPPORTUNITIES AND WHAT ARE THE CHALLENGES? STRATEGY MEETING ON RESOURCE MOBILIZATION FOR THE GLOBAL FUND TO FIGHT AIDS, TB AND MALARIA 28 JANUARY 2013, AMSTERDAM SOPHIE MÜLLER ADVOCACY OFFICER STOP TB PARTNERSHIP SECRETARIAT

2 SETTING THE STAGE "THE BURDEN OF TB"

3 The burden of TB – 2011 figures

4 Progress in TB still needs to take off 3 million TB patients never get their TB detected & treated Huge gaps in MDR-TB diagnosis and treatment Only half of HIV-positive TB patients receive ART & only 40% of TB patients are tested for HIV

5 WHAT'S NEW IN TB?

6 The window of opportunity is here  We have proven interventions and approaches  to detect and provide care for all TB patients  universal testing for drug resistance and several fold increase in coverage of services for drug resistant TB  Full coverage of TB/HIV care package to all HIV- associated TB patients, including TB testing of all PLHA and ART for all HIV positive TB patients  For the first time in four decades, we have new tools

7 GeneXpert – a powerful and affordable new diagnostic A new diagnostic tool endorsed by WHO in December 2010 A two-hour rapid diagnosis of TB and rifampicin-resistant TB Agreement between PEPFAR, USAID, UNITAID and Bill & Melinda Gates Foundation in August 2012 to expand access to GeneXpert GeneXpert is now available in over 70 countries at affordable prices (cartridges prices were reduced from US $16.86 to US $9.98)

8 Bedaquiline – first new TB drug in more than forty years FDA approved bedaquiline on 31 December 2012 as part of the treatment regimen for multidrug-resistant tuberculosis (MDR-TB) in adults

9 Other key developments For the first time in 40 years, a coordinated portfolio with 11 new or repurposed anti- TB drugs are in clinical trials Several new diagnostic tests are in development, including a point-of-care test The development of a new TB vaccine: Bacille Calmette Guerin (BCG) from 1921 is the only vaccine but unreliable against adult pulmonary TB. 11 vaccine candidates are currently in the pipeline – with the possibility of at least one new TB vaccine by 2020

10 ESTIMATED RESOURCES

11 Financing of TB – key facts = 5.5% of the overall needs for TB implementation = 90% of all external financing = 16% of all GF disbursements Needs US$ 8 billion Needs US$ 8 billion Gap US$ 3 billion Gap US$ 3 billion MDR-TB ~US$ 2,600 MDR-TB ~US$ 2,600 drug-sensitive ~US$ 30 drug-sensitive ~US$ 30 Global Fund US$ 440 million Global Fund US$ 440 million External US$ 480 million External US$ 480 million Annual financing for TB Annual financing for TB Composition of TB financing (2011) Composition of TB financing (2011) Cost of TB drug Cost of TB drug

12 Key challenges Weak voice of TB We are not ambitious enough. What is needed are ambitious scale-up plans for TB! We are "mortgaging" our future 3 million people had their active TB not detected and hence not treated in > but each TB patient risks infecting on average people The negligance towards drug-sensitive TB is the main reason for the emergence of drug-resistant TB MDR-TB patients were not treated in 2011 Being more efficient Prioritization of countries where the highest impact can be achieved Scale-up of drug-sensitive TB interventions Roll-out of GeneXpert Follow PEPFAR's Blueprint recommendation of targeting HIV-associated TB and providing ART for all TB patients In countries where HIV and TB are prevalent, testing for both should be provided to everyone

13 KEY ADVOCACY MESSAGES

14 Key messages TB patients rely on the Global Fund Thanks to the Global Fund, almost 10 million TB patients were diagnosed & treated – millions of lives were saved 90% of all available external financing for TB came from the Global Fund Missed opportunity – act today, not tomorrow We have never been as close to making a real difference in TB thanks to new approaches and new tools If we don't act today, an expansive and virtually untreatable disease (XDR-/TDR- TB) is emerging Smart investment TB is curable TB care delivers - proven track record of saving lives and growing economies TB is an inexpensive disease to treat and the costs stop after six months

15 THANK YOU Sophie Müller Stop TB Partnership Secretariat