Last week, heads of state and ministers of health from around the world came together for the United Nations High-Level Meeting (HLM) on Tuberculosis. This was only the fifth time that the UN had called for an HLM devoted to a health issue, with the first being on HIV/AIDS in 2001. At the meeting, member states agreed to a political declaration, “United to End Tuberculosis: An Urgent Global Response to a Global Epidemic.”

The declaration lays out targets for fighting TB, including successfully treating 40 million people with the disease and increasing global investments for ending TB to $13 billion per year by 2022.

In his comments on a multi-stakeholder panel at the HLM, Peter Sands, the Executive Director of the Global Fund, laid out three arguments for fighting TB and achieving these goals:

  1. Moral: Despite TB being preventable and treatable, there are still 1.3 million deaths from the disease among HIV-negative people and an additional 300,000 deaths among HIV-positive people, most of whom are among the world’s poorest.
  2. Economic: TB affects people at the prime of their lives and detracts from their ability to contribute to their family, communities and country.
  3. Global Health Security: Antimicrobial resistance (AMR) is a threat to health systems around the world, and drug-resistant tuberculosis is responsible for nearly a third of all AMR deaths today.

The question then is what are the next steps to achieve these goals? Without specific country targets and a way to hold governments accountable, countries must step up to show that they are serious about the commitments they made at the HLM.

The United States took an important first step at the HLM, announcing a new performance-based Global Accelerator to End TB that will catalyze investments to meet the targets set at the HLM, and committing up to $30 million to support efforts to end TB in India. Additionally, the United Kingdom announced £7.5 million to support the TB Alliance to develop new treatments that are shorter and more affordable to the world’s poorest countries.

These are important first steps, but if the United States is serious about ending TB, it must also ensure a successful Global Fund Replenishment in October of 2019. The Global Fund provides 65 percent of all international financing to fight tuberculosis, disbursing approximately $700 million annually on programs to combat TB. The Global Fund also uses its catalytic funding portfolio to find the estimated 3.6 million missing cases of TB that occurred last year. New investments in the Global Fund by the U.S. and other donors would have a substantive positive impact on our ability to achieve the goals laid out in the HLM’s political declaration.


Ultimately, there are two paths that the world can take. We can continue with business as usual and accept the two percent annual decline in TB incidence rate, or we can make the HLM a tipping point in the fight against TB, and hold our governments and each other accountable to the targets agreed to by the international community.