From September 18 to 25, the 78th session of the United Nations General Assembly, known as the High-Level Week 2023, will be held in New York City. A transcendental event due to the fact that it represents a milestone in the progress towards the goals of the 2030 Agenda. Likewise, this event gains relevance from the need to continue driving the commitment to the 17 Sustainable Development Goals (SDGs), which seek to promote peace, prosperity, progress and sustainability for all.
The high-level meetings come at a crucial time, just as the world is recovering from the ravages left by the COVID-19 pandemic and simultaneously facing various global humanitarian and environmental crises. Advocating for the human right to health and establishing equitable health care systems are essential elements in achieving universal health coverage. Therefore, eight key sessions will be on the agenda during this week:
- General Debate (September 19 to 25)
- Summit on Sustainable Development Goals (September 18 and 19)
- High-level Dialogue on Financing for Development (September 20)
- Summit on Climate Ambition (September 20)
- High-level Meeting on Prevention, Pandemic Preparedness and Response (September 20)
- Preparatory Ministerial Meeting for the Summit of the Future (September 21)
- High-level Meeting on Universal Health Coverage (September 21)
- High-level Meeting on Tuberculosis Control (September 22)
The General Assembly will hold the second high-level meeting dedicated to tuberculosis eradication under the theme: “Leveraging science, financing and innovation and their benefits to urgently end the global TB epidemic, specifically by ensuring equal access to prevention, testing, treatment and care.”. The session will bring together world leaders, public health experts, representatives of international organizations and civil society. As was the case last May, when the UN multi-stakeholder hearings on TB were held, Partners In Health will be present at the high-level meeting next September, through our Director General, Dr. Leonid Lecca.
The fundamental purpose of this high-level meeting is to address critical challenges in TB prevention and controlin the current context, which will serve as a crucial platform for discussing strategies and establishing new commitments in the fight against this disease, which remains a threat that claims the lives of more than 1 million people a year.
In this regard, during the multi-stakeholder hearings last May, a request was made to include six essential aspects of the TB issue in next September’s declaration. We review them below:
1. Reaching all people affected with TB with quality, evidence-based prevention, diagnosis, treatment and care actions according to the latest international guidelines.
National strategic plans to combat tuberculosis (TB) must be visionary and SDG-focused with the goal of eradicating TB by 2030, this includes strong commitments to detect, diagnose and treat more than 90% of affected people, including those with drug-resistant TB and children. It must also ensure early diagnosis using modern technologies and provide universal access to the best evidence-based interventions, including preventive treatments.
In addition, it is crucial to address the social determinants and factors associated with TB, such as mental health, nutrition, diabetes, smoking, poverty, climate and environment, to achieve a comprehensive approach in the fight against this disease.
2. Ensure national responses that are people-centered, equitable, inclusive, and with a human rights and gender focus.
It is essential to commit to ensuring that respect, protection and fulfillment of human rights and attention to a gender focus guide the TB response, actively involving affected people and civil society in the development of national strategic plans. By 2025, countries with high TB incidence are required to fund and implement plans that include concrete actions on Community Rights and Gender (CRG), prioritizing at least five key and vulnerable populations according to each country context. In addition, TB-related stigma should be addressed through stigma reduction plans that include: self-stigma, stigma in communities and stigma in health and care settings, as well as stigma related to discriminatory laws and policies.
3. Accelerate innovation, development and research in TB to generate a new vaccine against the disease and better tools for its diagnosis and treatment.
A global commitment to strengthen research and development (R&D) in the fight against TB is presented, which involves creating an environment for research that seeks to develop new tools to prevent, diagnose and treat TB in all its forms, including shorter and more effective treatment regimens, affordable diagnostics, innovative vaccines, and equitable access to these solutions. In addition, it recognizes the importance of addressing antimicrobial-resistant TB and promoting open data sharing and ensuring access throughout the R&D process, regardless of market exclusivity rights, to ensure that everyone benefits from scientific advances.
Dr. Leonid Lecca (seated on the left hand side) during the multi-stakeholder hearings held at UN headquarters last May.
4. Boost the investment and financing needed to end TB.
To scale up TB prevention, diagnosis, treatment and quality care globally, funding targets are needed that are estimated at US$22 billion per year by 2026 and US$35 billion per year by 2030, plus US$15 billion specifically for low- and lower-middle-income countries. It is also proposed to allocate US$ 5 billion for TB R&D, with a focus on drugs, diagnostics and vaccines, emphasizing equity in the contribution of all countries, increase domestic funding, ensure access to essential services, include key and vulnerable populations, and seek additional sources of funding, including the private sector.
5. Include TB at the center of discussions on universal health coverage, pandemic preparedness and response, and antimicrobial resistance.
As a first commitment, TB is to be incorporated as a central component of national pandemic preparedness and response programs, as well as infectious disease diagnostic networks, to ensure continuity of TB diagnostic, prevention and treatment activities during crises and outbreaks of other diseases. In addition, it promotes the participation of all care providers, public and private, the integration of TB services into universal health coverage and primary health care, the harmonization of regulatory policies and the elimination of barriers to efficient access to TB products.
On antimicrobial resistance, it aims to address this public health crisis through prevention, diagnostic and treatment measures, nationally leading the provision of access to new tools to combat drug-resistant TB (DR-TB) by ensuring a safe and quality supply chain of TB drugs, and monitoring drug resistance and treatment safety.
6. Ensure accountability mechanisms at global, regional and national levels, with civil society involvement in monitoring.
At the global/regional level, a commitment to hold a follow-up session of the High-Level Meeting on TB in 2028 is sought, as well as a call for annual public reporting on TB-related financing and progress towards disease eradication, as part of the follow-up to the SDG targets. At the national level, it is key to incorporate the global goals and commitments of the High-Level Meeting on TB into national frameworks and legislation, as well as to conduct annual high-level national reviews of progress in the fight against TB. Also, engage affected communities and civil society in the governance of TB mechanisms, and establish public accountability frameworks.
This high-level meeting will culminate with the adoption of a Final Declaration that will synthesize the agreed commitments and actions, and will become the roadmap that will guide global efforts in the fight against TB in the coming years.
The inclusion of the six key points for TB is a request that is expected to be materialized to positively impact the fight against tuberculosis, which claims 1.6 million lives a year and where Peru concentrates, approximately, 14 % of the cases in the Americas region.