Despite being preventable and curable, TB is the leading cause of death in the world from infectious disease. So there is every reason to set ambitious targets, as we did in the U.N. declaration on TB. But achieving them will require a comprehensive response.
As Prepared for Delivery
Thank you, Dr. [Judy] Monroe and the CDC Foundation, for hosting us today.
I’d like to offer an additional welcome on behalf of myself, the Department of Health and Human Services, and the U. S. government.
Today, we attended the High Level Meeting on Tuberculosis together, and I hope that you and your delegations took away the same message we did.
Simply, the world must do more to end TB.
We are not on track to meet the goals set out in the WHO End TB strategy. We heard from governments, experts, and, most important, TB patients themselves. From our perspective, the call to do more was clear.
But just because there is a clear need doesn’t mean there are simple answers.
Despite being preventable and curable, TB is the leading cause of death in the world from infectious disease. So there is every reason to set ambitious targets, as we did in the U.N. declaration on TB. But achieving them will require a comprehensive response.
Moving ahead, three TB objectives are paramount: increasing the number of people diagnosed and effectively treated; rapidly scaling up effective existing tools, including TB preventive therapy; and developing new tools to prevent, diagnose and cure the disease.
To support these objectives, as I outlined today, the U.S. government will sustain its strong commitment to research that will lead to a more complete understanding of TB and the development of new vaccines, diagnostics and treatments.
You’ll hear more in a little bit from the National Institutes of Health and the Centers for Disease Control and Prevention, who will speak about the cutting edge work they are doing to prevent and control TB.
As new tools are developed, we look forward to expanding our research partnerships with high-burden countries to ensure all the needed resources are committed, by the U.S. and by other countries, to conduct critical clinical trials. As the long-standing provider of the bulk of TB research funding, we also call on other countries to expand their funding for TB research.
Ending the global threat of TB will require addressing a few particular elements of the epidemic as well: the co-epidemic of HIV-associated TB, the 40 percent of TB cases that go undiagnosed and untreated, and the rise of drug-resistant strains of TB.
Globally, TB is the leading cause of death among persons living with HIV, and in many parts of the world the two epidemics are feeding off each other. Ending TB among persons living with HIV will require expanded access to antiretroviral therapy for all persons living with HIV, integrated TB and HIV service delivery, and aggressive scale-up of TB preventive treatment.
We could also be doing more to break the cycle of TB transmission. One-fourth of the world’s population is infected with TB, at risk of developing active disease and transmitting it to others. But this cycle can be blocked through TB preventive treatment, the specific issue we have all gathered here today to discuss.
The United States is also intently focused on the challenge of drug-resistant TB. Last night, I launched the AMR Challenge, a U.S. government-led effort to garner international support across sectors to combat antimicrobial resistance, including TB.
I hope you will all consider joining this challenge, which has already attracted commitments from more than 100 countries and organizations.
Domestically, we hope our TB program can be a model for the world. The United States has one of the lowest case rates globally, in 2017 reporting just 9,000 cases of TB. Over the past two decades, U.S. TB control efforts have prevented an estimated 319,000 cases of TB and averted $14.5 billion in healthcare and social costs.
But our efforts still can be improved. More than 80 percent of TB disease in the United States resulted from long-standing, untreated latent TB. Approximately 13 million people in the United States have the latent form of the disease, and without treatment, they are at risk for developing active TB. To eliminate TB, we will need to increase capacity to diagnose and treat people facing this issue.
Given historical U.S. leadership in fighting the global burden of TB, we are so pleased that the U.N. convened this high level meeting, a welcome opportunity for governments and heads of state to join together in this fight.
The TB situation demands a breakthrough moment, where the global community comes together to support new ways to fight the disease while each country takes the necessary steps within its own borders.
I am so happy to be here leading the U.S. delegation in that effort. If everyone takes from this week’s events a serious commitment to doing what their countries can to end TB, I believe this week can be the start of that breakthrough moment we need. Thank you very much.
