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Tag: TB

  • WHO calls for urgent action to end TB

    The World Health Organisation ( WHO ) has called for urgent global action to end Tuberculosis (TB), the world’s deadliest infectious disease which claims 4000 lives daily. The call was made at a press conference to launch the 2018 Global Tuberculosis report, held yesterday at the United Nations headquarters in New York.

    The report provides a comprehensive assessment of the TB epidemic, with data on disease trends and response in 205 countries and territories. It also outlined a monitoring framework with data on SDG indicators and a graphic country profiles from the top 30 high-TB-burden countries.

    According to the report, Nigeria’s TB treatment coverage stands at 24 percent with 155 000 deaths, including 35 000 deaths among people with HIV. Also, 24, 000 people fell ill with drug-resistant TB while 58, 000 people living with HIV fell ill with TB. The TB cases in Nigeria were attributed to five risks namely alcohol, smoking, diabetes, HIV and undernourishment.

    The Director, Global TB Programme, WHO, Dr Tereza Kasaeve called for urgent actions to close the gaps and reach all people affected with TB worldwide with proper care. In a chat with The Nation, Dr Irene Koek, the Deputy Administrator for Global Health, US Agency for International Development (USAID) charged leaders from African countries to recognizeTB as an important issue that demands urgent attention with political commitment which invests in the needs of patients and health systems.

    Heads of State are expected to meet at the first-ever United Nations General Assembly High-level Meeting on TB on 26 September in New York, to commit to accelerate the TB response.

  • Kano gets TB mobile detection facility

    The Minister of Health, Prof Isaac Adewole, the Emir of Kano, Muhammed Sanusi II, and Kano State Governor Abdullahi Ganduje have inaugurated a TB mobile detection facility in Muhammadu Buhari Specialist Hospital Kano.

    They also launched Access to Care for Enrollees of Kano State Contributory Health Scheme (KSCHS), Free Breast Cancer Screening Programme for 1,000 women as well as distribution of laptops and internet moderms to Roll Back Malaria (RBM) Officers.

    Speaking on the projects, the minister said: “People like you make my work easy, while some call on me to help them but the message from your Excellency  is come and see what we are doing”

    He added that the “Wellness on Wheels (WoW) programme on TB was aimed at providing diagnostic facility and treatment to tuberculosis patients at their door step,” adding that, “Nigeria was one of the countries with large number of undetected TB patients in the world, Nigeria detected only 25 percent the remaining 75 percent Patients were not known and they also do not know that they were TB Patients.”

    Ganduje said the rationale behind establishing Muhammadu Buhari Specialist Hospital was to provide services not only to Kano State populace, but to the entire country.

    He said: “Our intension is not only to serve the people of Kano state but to make Kano center of medical tourism in order to reduce foreign medical tourism.”

    Emir Sanusi called on Nigerians, especially the wealthy, to support government at all levels with health facilities and equipment as the government alone could not cater for the need of all Nigerians in the health sector.

     

  • Institute advocates improved data collection in Nigeria

    Institute advocates improved data collection in Nigeria

    Dr Patrick Dakum, the Chief Executive Officer, Institute of Human Virology, Nigeria (IHVN), on Wednesday called for an improved data collection system in Nigeria.

    Making the call at the 3rd Annual Nigeria Implementation Science Alliance (NISA) Conference holding in Abuja, Dakum noted that the key objectives of the conference was to provide a forum for dissemination of research data.
    He said that data would make research and implementation easier and more effective.

    “Correct data at the correct time will give you correct result and correct impact of what you are doing.

    “IHVN will work with hospitals to change perspective on data especially how they use their data for programming at their own site level.

    “We will also harmonise our electronic platforms, so that we can have a uniform platform that fits data into the federal system.

    “There is a national data platform called the National Data Health Information System and stakeholders have agreed to key into it.

    “They have also agreed to upload data into it and to ensure that whatever data is available is put in the National repository, so that it can be used for planning, budgeting and for taking care of patients,” he added.

    Dakum also urged the government to take full responsibility and ownership of the different health programmes in Nigeria.

    The IHVN boss also cautioned that Nigeria could not continue to depend on foreign grants as 75 per cent of drugs consumed by people living with HIV and AIDS and TB in the country were paid for by funders.

    According to him, in the issue of funding and sustainability, Nigeria is below 28 per cent in terms of government responsibility in taking care of HIV and TB.

    “This is not right, we must push and advocate for better implementation and ownership of the different health programmes in Nigeria, not only HIV and TB but also the communicable diseases,” he said.

    NISA Conference Coordinator, Prof. Echezona Ezeanolue, highlighted the main objectives of the conference to include providing a forum for dissemination for researchers, implementers and policy makers, to review challenges and identify new strategies in implementation science.

    Ezeanolue said that other objectives of the conference were enhancing collaboration and creating opportunity for young investigators to identify mentors and and collaborators as part of their objectives and the provision of a forum for dissemination of research data generated from Nigeria to inform local policy changes.

    The Chief Executive Officer, AIDS Prevention Initiative in Nigeria, Prosper Okonkwo, said that there was need to increase awareness about research in the country.

    According to Okonkwo, the Nigerian government has the capability to fund and encourage research to improve scientific work.

  • Reprieve for TB patients in Ebonyi

    Reprieve for TB patients in Ebonyi

    In a visit to Ebonyi State, Minister of Health Professor Isaac Adewole revealed that Nigeria is among six countries that account for 60 per cent of new cases of tuberculosis globally. He noted that Nigeria ranks fourth among the 30 high tuberculosis countries and is number one in Africa.

    It is on account of this that the donation of a fully equipped chest clinic to the state government by a consortium of oil firms under the umbrella of Agbami Partners, is a very good development.

    The facility was provided for the Mile Four Hospital, Abakaliki, the state capital.

    The donor consortium is made up of FAMFA Oil limited, Petrobras, Statoil, Chevron and Nigeria National Petroleum Corporation (NNPC).

    The Mile Four Hospital was established in 1946 by the Catholic Church to provide specialised care to sufferers of tuberculosis in the Southeast.  Inaugurating the project, Professor Adewole announced that the federal government was making efforts to achieve the target of providing one machine per local government area across the country for the fight against tuberculosis epidemic.

    According to him, the machine would not only provide GeneXpert MTB/RIF technology as the primary diagnostic tool for TB among all presumptive TB cases in the country including PLWHA but also increase the number of notified TB cases, especially in the rural areas.

    The Minister who commended the initiative and contribution of the church in providing quality healthcare for the people added that tuberculosis remains a serious public health problem in most parts of the world causing deaths of nearly one-and-half million people each year, mostly in developing world.

    In a remark, the Group General Manager, NAPIMS, Mr. Dafe Sejebor, who stated that the project was aimed at facilitating the socio-economic development of the country, added that the commitment of the agency is to see that the standard of living and quality of life of Nigerians were improved upon daily. Represented by Uzo Ejidoh, the group General Manager added: “I am happy to note that the Agbami partners remain committed to improving the quality of healthcare in our society through the provision of infrastructures such as Chest Clinics to address chest-related ailments”.

    In their separate remarks, the Chairman, FAMFA Oil Limited, Modupe Alakijia and Director, Star Deepwater Petroleum Limited, Richard Kennedy represented by Obinna Iheonu and Mike Kabi of Deepwater Community Engagement Advisor respectively, the duo stated that Agbami partners had so far donated 25 chest clinics to different states of the federation including the Federal Capital Territory, FCT.

    They said the chest clinic came with fully equipped standard X-ray machine, male and female wards, treatment rooms, laboratories and GeneXpert machine.

    Commissioning the project, Governor David Umahi of Ebonyi State commended the benefactors for the initiative adding that they have through the execution of the project fulfilled their corporate

    responsibility to the society.

    Umahi who was represented by the State Commissioner for Health, Dr. Daniel Umezurike expressed hope that the Chest Clinic would help to tackle incidences of tuberculosis and other health related issues in the state even as he x-rayed some of the contributions of the present administration in the area of combating malaria, TB and HIV/AIDS.

  • Sustain the gains on AIDS, TB and Malaria

    Atinuke recently completed her national youth service having graduated from the University of Ibadan in 2014 where she read Pharmacy. She was born HIV positive in 1990. Now 26, she has lived with the disease all her life. She had once coped with TB co-infection but being the fighter she is, had beaten TB hands down. Both her father and mother are also HIV positive, everyone is fine now, with undetectable viral loads, a clear indication of the progress in HIV/AIDS treatment.

    Atinuke and her family represents a generation of Nigerians whose lives were shaped by HIV/AIDS in its entirety, and they come not in small numbers, with 3.4 million Nigerians projected to be living with HIV/AIDS. For Atinuke and others in her shoes, they got a second shot at life and are able to live productive lives because of the programmes being supported by the Global Fund which provides treatment ensuring they can have children of their own who are free of the burden of the disease. It is instructive to note that several others are not as lucky as Atinuke, lacking every access to the life-saving treatment they require.

    HIV/AIDS remain a major development crisis. Since the pandemic began, it has killed millions, separated families, and destroyed and impoverished communities. In some countries, life expectancy has fallen by more than 20 years. The scale of the epidemic is causing informal social safety nets to collapse. Overall, health care is under pressure as health services struggle with mounting demand. Workforces are being decimated, with severe consequences for investment, production, and per capita income while posing as a severe threat to global health, development, and security.

    In retrospect, we have to appreciate the tremendous progress that has also been made in the fight against the three diseases achieving life-saving impacts that were unthinkable at the turn of the millennium. In 2000, just 50,000 people were receiving antiretroviral (ART) therapy in sub-Saharan Africa, but by 2011, it had climbed to over 7 million. Now, more than 17 million lives have been saved. Current projections show that more than 2 million lives are being saved each year. About 8.6 million people are receiving lifesaving antiretroviral therapy for HIV and 16 million people with HIV-TB co-infection have been treated. Nearly 3.3 million mothers have received treatment to prevent the transmission of HIV to their babies and 560 million people with malaria have been treated.

    However, if global funding for HIV / AIDS and TB were to remain static as we are currently experiencing, some of the consequences would include: 2.6 million new HIV infections every year, of which 1.3 million could be averted through scale-up. In total 3.9 million new HIV infections was projected for the period 2014-2016 and $47 billion of costs throughout the lifetimes of those additional people infected. Three million less people will be treated for TB and one million lives would be unnecessarily lost with uncontrollable multi-drug resistant TB (MDR-TB) if we don’t treat TB now for as little as $30 per patient because MDR-TB can cost up to 1000 times more to treat. It will also mean 196,000 lives lost to Malaria per year and 430 million malaria cases that could have been prevented, according to Cost of Inaction, a report on how inadequate investment in the Global Fund to fight AIDS, Tuberculosis and Malaria will affect millions of lives across the globe.

    It is crucial to acknowledge that the fatigue in donor replenishment of the Global Fund is coming at a time that experts have suggested offers the most hope in the fight against HIV, TB and malaria. It therefore goes to show that the Global Fund needs a robust infusion of pledges from traditional donor countries most notably world economic powers such as Germany and China, to successfully hit, and hopefully exceed, the fundraising target of $13 billion for the Fifth Replenishment Round.

    It is in this regard that we must acknowledge the AIDS Healthcare Foundation (AHF) and its global partners on the launch of The Fund campaign targeting countries like Germany, Japan and China to act in the interest of humanity and increase their contributions to the Global Fund. Across AHF country programmes, Nigeria inclusive, various activities have been launched, ranging from advocacy meetings with country reps at various embassies to staging press conferences to put the issue on the global agenda and highlight the sense of urgency.  In May, Japan announced a contribution of $800 million for the fifth replenishment of the Global Fund to fight AIDS, TB and Malaria which shows AHF’s effort and messages is reverberating.

    Nowhere else can the Global Fund’s impact be louder than Nigeria where the Fund has provided HIV care and treatment to 750,000 people, ensuring TB treatment to 310,000 as it provided 93.4 million mosquito nets to households to ward off malaria. Nigeria also currently represents the Global Fund’s largest portfolio with a total of $1.1 billion allocated to fighting the three diseases from 2014-2016. Unfortunately, since 2010, the Global Fund has never achieved its targeted funding. Therefore, increasing and sustaining the funding to the Global Fund is imperative to sustaining the gains achieved over the last decade, and the last few years in particular.

     

    • Aborisade is Founder/Coordinator, Projekthope.
  • ‘Nigeria needs to invest N640b to tackle TB’

    ‘Nigeria needs to invest N640b to tackle TB’

    The Federal Government needs to invest $2 billion about N640b in the next five years to fight Tuberculosis, it was learnt yesterday.

    Nigeria is rated as the world  fourth highest Tuberculosis burden nation and number one in Africa, with about 600,000 patients on yearly basis.

    The  treatment of tuberculosis is free in the country, though only about 90,300 patients have been detected for treatment.

    Speaking ahead of a two- day National Tuberculosis Conference Abuja 2016 scheduled for Tuesday, next week, Country Representative Dr. Mustapha Gidado, said with the efforts in place now,  it is criminal for anybody to die of TB in the country.

    Gidado noted that the disease is curable and preventable; stressing that there were over 500 treatment points in the country.

    He, however, noted that the country still has a funding gap in meeting with the five years national strategic plan.

    He said: “The current national strategic plan which is from 2016- 2020, is going to cost above $2billion. But this will help Nigeria to diagnose no fewer than 600-1million cases of Tuberculosis. But if these cases are found on time, this will help us to prevent over 35 million people from being infected with tuberculosis.

    “So the cost will look very very high, but if you look at it over a period of five years and amount of lives, Nigeria is going to save, and those that will be prevented from being infected, I think it is not expensive as we think.

    “Nigeria still enjoy significant support from global fund and USAID, at the same time, Nigeria  is still ranked among the countries with the highest gap in  funding of tuberculosis”

    He therefore hinted that one of the reasons for the conference is to galvanise political commitment at all level of government to ensure we get the resources to fight tuberculosis.

    He stressed that the disease is curable and preventable, hence, it is criminal to see any Nigeria die of TB.

    On the coming conference, Gidaldo said participants would be afforded to learn the latest TB treatment techniques.

    Also, on the awareness, Dr. Ayodele Awe, World Health Organisation (WHO) representative said there was need for creation of more awareness on TB.

  • TB crisis

    •We cannot afford the tragedies

    March 24 was World Tuberculosis Day, and it was appropriate that the Minister of Health, Prof. Isaac Adewole, took advantage of the occasion to highlight the scope of the country’s tuberculosis (TB) crisis. He said at an event organised to mark the day in Abuja: “Today, tuberculosis remains an epidemic in different parts of the world, leading to annual deaths of nearly 1.5 million people, mostly in developing countries. In Nigeria, it is estimated that we record quite close to 250,000 deaths every year.” In addition, Adewole stated that among the 22 countries that accounted for 80 percent of TB cases, Nigeria was number four, coming behind India, Indonesia and China.

    This year’s World TB Day theme “Unite to End TB” is a call for increased cooperation against the disease, which is considered a global public health issue. Disturbingly, Adewole observed that a 2015 health report indicated that of the estimated 9.6 million TB cases worldwide, only six million cases had been detected, and an estimated 3.6 million cases were either undiagnosed or diagnosed but unreported.

    More alarmingly, the minister was quoted as saying: “Of this group, Nigeria accounts for 15 per cent of the gap in TB case notification. The implication is that one out of six cases of TB is only detected and five out of six roam around undetected. In other words, everybody is not safe.”

    This depiction is not exaggerated. The danger posed by TB is not overstated. According to the World Health Organization (WHO), TB is “caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs…TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.”

    WHO further said: “When a person develops active TB (disease), the symptoms (cough, fever, night sweats, weight loss, etc.) may be mild for many months. This can lead to delays in seeking care, and results in transmission of the bacteria to others. People ill with TB can infect up to 10-15 other people through close contact over the course of a year. Without proper treatment up to two thirds of people ill with TB will die.”

    The phenomenal figure of fatalities connected with TB in Nigeria calls for an urgent intervention by the health authorities. There is a need for the country’s health officials to intensify TB public awareness efforts. It is noteworthy that Adewole noted important focus areas in the anti-TB campaign, particularly the emergence of drug-resistant TB and its impact on the country’s control efforts as well as the negative effect of the interaction between TB and HIV. He stated: “Of the 250,000 TB death cases recorded, one-third have HIV infection.”

    It is a cause for concern that the country’s TB battle is hampered by funding. The minister said: “For instance in 2015, only 32 per cent of the $228m required was released, leaving a funding gap of $155m.” It goes without saying that this huge difference between required funds and received funds is a huge reason the TB burden is so huge in Nigeria.

    It is reassuring that Adewole said that funding for the control of TB was appropriated in the 2016 budget. However, it should be stressed that his ministry must ensure that the budgeted funds are used appropriately.

    Even more reassuring is the minister’s promise for next year. Adewole said: “In the 2017 budget, I promise you that we shall increase our funding support for tuberculosis.” The idea of uniting to end TB, which is the message of World TB Day 2016, means that governments, communities, civil society, and the private sector should all be involved in the fight against TB.

  • Why TB war must be won, by doctors

    Why TB war must be won, by doctors

    Doctors have joined the World Health Organisation (WHO) in drawing the battleline against tuberculosis (TB).

    The Association of General Private Medical Practitioners of Nigeria (AGPMPN) has dedicated its forthcoming 38th Annual General Meeting and Scientific Conference to fight the killer-disease in line with WHO’s call on its member-countries and partners to “Unite to end TB”.

    AGPMPN, which AGM holds in Abuja on April 14, plans to collaborate with the National Tuberculosis and Leprosy Control Programme (NTLCP) to fight the scourge.

    Chairman, Scientific Committee for the AGM/Scientific Conference Dr Biodun Ogungbo said AGPMPN is partnering with Global Fund, United States Agency for International Development (USAID), WHO and Clinton Health Access Initiative, among others, to fight AIDS, tuberculosis and malaria because private hospitals exist in every part of the country.

    The group can also work towards a functional referral system for TB patients.

    Ogungbo described his group’s effort to end the scourge as timely as WHO’s End TB Strategy aims to reduce TB deaths by 90 per cent and new cases by 80 per cent by 2030

    “Though WHO said there has been significant progress in the fight against TB, with 43 million lives saved since 2000, but despite these advances, formidable challenges remain, including fragile health systems, human resource and financial constraints, and the serious co-epidemics with HIV, diabetes, and tobacco use.

    “MDR-TB is another critical challenge. Urgent and effective action to address antimicrobial resistance is important to ending TB by 2030. So are increased investments, as the global tuberculosis response remains underfunded for both implementation and research.

    “And the AGPMPN going with this year’s ‘Find TB, treat TB and working together to eliminate TB’ with the slogan ‘Unite to end TB’, is re-strategising along with Federal Government through the National Tuberculosis and Leprosy Control Programme (NTLCP). The diagnosis and treatment of tuberculosis are provided free of charge by the body,” Ogungbo said.

    TB, he said, could be diagnosed with a simple laboratory test, using a sputum sample. ”The laboratory diagnosis rests mainly with the identification of the tubercle bacilli in a clinical specimen (sputum, other bodily fluids such CSF) by using available laboratory methods, microscopy, culture and GeneXpert MTB/RI. The test GeneXpert MTB/RI and others have the potential to revolutionise the diagnosis of TB. Other methods such as a good history of contact with a sufferer, a chest x-ray and a skin test are also important,” he said.

    The association said its efforts would yield results and further reduce the cases of TB and drug resistance.

    “The collaboration will enhance the number of diagnostics, treatment and research centres across the country. We need private hospitals to take custody of some of the diagnostic kits and drugs for easy access by patients. This will also allow for good monitoring, evaluation, thus spreading the catchment net widely. This is also in the spirit of public private partnership (PPP) in health care as majority of Nigerians patronise private hospitals and clinics,” Ogungbo said.

    Chairman, Stop TB partnership in Nigeria Dr Lovett Lawson and her team members, including Dr Gabriel Akang, Dr Josephine Okechukwu and Dr Emmanuel Meribole, all of NTLCP are expected at the AGM.

  • CSOs to increase awareness on TB, malaria

    TWO Non-Governmental Organisations; Positive Action for Treatment Access (PATA) and Open Society Initiative for West Africa (OSIWA), have rallied civil society organisations (CSOs) to increase understanding and engagement of communities and key stakeholders in Global Fund AIDS, Tuberculosis and Malaria (ATM) projects in Nigeria.

    The 60 CSOs involved are in Lagos, Enugu and Abuja.

    At a two-day seminar in Lagos, PATA said: “Our conviction is that through partnership with in-country Global Fund structure (CCM), Nigerians can improve quality of their lives through access to GF projects across Nigeria.”

    Speaking at the workshop, Mr. Peter Ujomu, of the Health Matters Incorporated, encouraged CSOs to be committed to the task of making people know about tuberculosis and malaria treatment.

    Ujomu urged them to be skilful, passionate and creative, to encourage funding and state the problem on their proposals before grants can be given.

    Speaking on monitoring ATM projects in Nigeria, the Senior Programme Officer-Technical at Hygeia Foundation, Mr. Wilfred Ugwoeruchukwu, pleaded with CSOs to contribute its quota to health matters.

    “Nigeria has strong individuals but need strong institutions to check and balance system.”

    He advised HIV-positive mothers to always ensure they attend antenatal care to prevent their children from contracting it.

  • Health experts unite against TB and diabetes in Bali Declaration

    Health experts unite against TB and diabetes in Bali Declaration

    As a way of combating the twin epidemics of TB and diabetes, a coalition of health officials worldwide and experts have united to fight the twin scourge. This was part of the resolution taken at the recently held two-day summit in Bali, Indonesia at the end of which the Indonesian Ministry of Health, together with the International Union Against Tuberculosis and Lung Disease and the World Diabetes Foundation, signed the Bali Declaration.

    The Declaration follows data presented at the summit by the Indian initiative, Jagran Pehel showing that after bi-directional screening of more than 50,000 people for TB and diabetes in 10 districts from the states of Bihar, Uttarpradesh and Jharkhand between September 2014 and September 2015, one in four people infected with TB was also positive for diabetes.

    Bi-directional screening is a key component of the Bali Declaration, which aims to bring the co-epidemic to the attention of governments across the globe.

    The Bali Declaration states that tuberculosis and diabetes represent two of the greatest global health challenges of our time, and their convergence globally represents a looming co-epidemic. This looming co-epidemic threatens progress against TB and basesd on what we have learned from past co-epidemics, particularly TB-HIV, we must act early and decisively to avoid large numbers of avoidable deaths.

    “Today we’re committing to take action to stop this double threat,” said José Luis Castro, Executive Director of the International Union Against Tuberculosis and Lung Disease. “We have evidence and we have practical solutions, such as providing TB patients with screening for diabetes and vice-versa. In countries facing this challenge, health systems need to take these solutions off the shelf and put them to work.”

    Diabetes weakens the immune system, and triples a person’s risk of getting sick with TB—which killed 1.5 million people in 2014, according to a new World Health Organization report. Today, 387 million people are affected by diabetes, with 77 per cent of cases in low- and middle-income countries where TB is prevalent. Diabetes is projected to affect 592 million people by 2035, which experts project will only fuel the global TB epidemic.

    “Healthcare systems must prepare to deal with this challenge, particularly in low- and middle-income countries where the challenge is most severe,” said Anders Dejgaard, Managing Director of the World Diabetes Foundation. “It can be done. Leadership in training and advocacy will be essential to ensure that healthcare professionals are equipped to diagnose and take care of these two diseases as they increasingly appear together in the same patients.”

    TB, number one infectious disease

    The Declaration was issued on the heels of a new WHO report showing that due to TB’s slow rate of decline worldwide relative to HIV/AIDS, TB has overtaken HIV as the leading cause of death from an infectious disease.

    Presently, the World Health Organisation (WHO) ranks Nigeria as having the highest tuberculosis (TB) prevalence rate in Africa and 11th among the 22 high burden countries in the world that account for 80 per cent of global TB burden with a total of 180,000 cases occurring annually in Nigeria.

    The burden of the disease in Nigeria is further worsened by the negative effects of the interactions between TB and HIV, leading to the deaths of 27,000 persons annually. On the link between TB and HIV, Dr Sunday Amosun, a Consultant with the Psychiatric Hospital, Aro, Abeokuta, stated: “Tuberculosis is caused by micro bacteria and it is common among those whose immunity is down; that is why it is common among those who have HIV because what HIV does is to knock out all the immune system.”

    Indeed, TB has been variously described as the most common life-threatening disease and the number one killer among ‘people living with HIV’.

    TB and diabetes interact with each other on a number of levels, with each disease exacerbating the other. Diabetes triples a person’s risk of developing TB. Among people who are being treated for TB, those with diabetes remain contagious longer, respond less well to TB treatment and have a significantly higher likelihood of a recurrence of TB after successful treatment or dying from the disease.

    TB can temporarily increase the level of blood sugar, a condition known as impaired glucose tolerance, which is a risk factor for developing diabetes. Moreover, some drugs used to treat     TB (especially rifampicin) can make it more difficult to control diabetes due to the way that they interact with oral diabetes medications. There are growing concerns that oral diabetes medicines can decrease the effectiveness of TB medicines. Clinicians do not yet know how to optimise glucose control in people who have both TB and diabetes.

    TB killed an estimated 1.5 million people in 2014 according to the World Health Organization—making it the world’s leading cause of death from an infectious disease. One in three people worldwide are living with a latent TB infection that could develop into active TB disease at some point in their lives.

    Six of the 10 countries projected to have the greatest numbers of people living with diabetes by the year 2035—China, India, Brazil, Indonesia, Pakistan and the Russian Federation—are also classified as high TB-burden countries by the World Health Organization.

    The Bali Summit convened just a few weeks prior to the 46th Union World Conference on Lung Health in Cape Town, South Africa, the world’s largest gathering of TB experts, advocates and members of TB-affected communities. The conference’s theme, A New Agenda: Lung Health Beyond 2015, reflects in part the changing nature of the TB epidemic. The conference will feature a special session on TB-diabetes following up on the Bali Summit. The conference is expected to draw roughly 3000 delegates from more than 100 countries, including key ministers of health, parliamentarians, and heads of global health financing organisations.