Academic journal article Bulletin of the World Health Organization

New UN Envoy Joins Campaign to End TB: Eric Goosby Tells Fiona Fleck Why Tuberculosis Prevention and Care Should Be Integrated into a Comprehensive Package of Health Services for Which Universal Health Coverage Is Essential

Academic journal article Bulletin of the World Health Organization

New UN Envoy Joins Campaign to End TB: Eric Goosby Tells Fiona Fleck Why Tuberculosis Prevention and Care Should Be Integrated into a Comprehensive Package of Health Services for Which Universal Health Coverage Is Essential

Article excerpt

Q: What are the key challenges of the global tuberculosis response?

A: We have known about tuberculosis for hundreds of years and for the past 50 years we have known how to prevent, diagnose and, in most instances, cure it. The major challenge--in. rich and poor countries alike--is that tuberculosis has always been more prevalent among people in lower socioeconomic groups, who often have difficulty accessing treatment and completing the full course of treatment as prescribed (an average treatment course is six months for drug-susceptible tuberculosis and up to two years for drug-resistant types of the disease). Other challenges include the need to improve diagnostics for tuberculosis, for more prompt detection, and to develop medicines that would allow for shorter courses of treatment. In Africa, a major challenge is, of course, HIV-associated tuberculosis, while drug-resistant forms of the disease, especially in eastern Europe and Central Asia, require focused efforts in the global response.

Q: How do you plan to address these challenges?

A: The World Health Organization's (WHO) post-2015 End TB Strategy sets a clear response. In my position as Special Envoy on Tuberculosis and in partnership with WHO, I will endeavour to work with ministries of health--particularly those in high-burden countries--to strengthen prevention efforts through aggressive contact tracing, so that people with tuberculosis are identified as early as possible and provided with treatment. If we can get patients on treatment, we can cure them. I am confident that by refocusing our attention on the basics, we can strengthen service delivery in most countries. Also, by providing technical assistance to help boost the capacity of each ministry and by drawing on community-based strategies, we can save many lives. I will also work to build links with other ministries such as those responsible for social welfare, justice and immigration to address the social determinants of tuberculosis. In addition, I will also work with the academic and private sectors to advocate for more research and development of new vaccines, drugs and diagnostics.

Q: How will you support the new WHO End TB Strategy?

A: First, my office will work with WHO and its partners to encourage countries to adopt the strategy with its commitment to drive down deaths globally by 95% and end the global epidemic by 2035.1 will support WHO to continue to provide countries with the relevant guidelines and norms they need for their tuberculosis programmes, while raising the global profile of tuberculosis on the political and development agenda. Second, we will support strategies to target clinical officers, nurses and other health workers, who play a huge role in the diagnosis and treatment of patients to boost their skills and understanding of the new strategy. Finally, ensuring the engagement of civil society and the private sector will also be crucial for the achievement of the ambitious targets of the End TB Strategy. Therefore, we will focus on engaging the community --both infected and affected--to raise awareness of the need to identify people at risk of tuberculosis, to diagnose those infected and to retain them in care for prophylaxis or treatment. In this way, we will empower people affected by tuberculosis to demand services from their public health systems.

Q: Can you describe your early experience treating patients with HIV? What was remarkable about this experience and what lessons do you bring from this to the global fight against tuberculosis?

A: I trained at San Francisco General Hospital (SFGH) from 1974 to 1984. Many of the first patients with HIV came into our emergency department and--in the early years--filled inpatient units around the city. Our centre initially saw more HIV cases than anywhere else in the United States and San Francisco General--part of the University of California Clinics and Hospitals--was the first hospital to devote whole units to HIV: both an outpatient clinic, called Ward 86, and an inpatient unit called Ward 5. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.