Richer nations, like Australia for example, were able to deploy age-old tools in 1960s-1970s to screen everyone and find all TB, treat all TB and prevent all TB. The rate of TB in some of the richer nations is already at the much sought after elimination levels. Then why was it not replicated to fight TB in the rest of the world?
Sumit Mitra, President of Molbio Diagnostics and a thought leader on point-of-care and point-of-need diagnostics, spoke in the recently concluded World Social Forum 2024 (WSF 2024). He wondered that when less than a quarter of the world's population lives in the Global North (richer nations) then why do those in the Global North have decision-making powers when it comes to global health - especially when health challenges are way more profound in the Global South?
What works really well in the Global North may not work well in the South. Health technologies conceived, designed, and manufactured in the Global North, and funded mostly by the Global North, are being rolled out in the Global South in a way those sitting in the North decide, said Mitra.
"I have every right to demand the best possible diagnosis and treatment. Just because someone is born in the Global North, her/ his/ their right to a healthy life is not in any way higher than mine," added Mitra.
There are inequities and injustices within richer nations too. But global health challenges in the Global South are so predominant and deadly that they are thwarting health security and sustainable development.
The deadly divide in 2024
WHO's highest level initiative Find.Treat.All - backed by Stop TB Partnership and others (first launched in 2018), calls upon all countries to replace a TB test (microscopy which underperforms in diagnosing TB) 100% with WHO recommended highly accurate molecular tests by 2027. But only 47% of those with TB disease got a molecular test diagnosis in 2022 as per the WHO Global TB Report 2023. If we use a bad test that underperforms in diagnosing TB (like microscopy) we will miss TB even among those who take that test. These people who are not accurately and timely diagnosed suffer unnecessarily due to TB, as well as the infection keeps spreading from one person to another. Making upfront molecular test diagnosis is an essential cog-in-the-wheel to finding all TB - and entrygate to TB care pathway.
Addressing human-made inequities that jeopardise access to TB care services remains a critical bottleneck. We are failing to 'reach the unreached' - at least one-third of the estimated people with TB globally are not notified to TB programmes (we do not know how, if at all, they get a TB test or treatment or any other care or support). Walking the talk on what Mitra and Dr Ditiu have said - to end inequities in global health - is key. Let us take the best of existing TB services equitably to the communities (and closer to the people) in high TB burden settings with dignity and respect.
Linking all those diagnosed with effective and best of WHO recommended treatments is vital.
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