Debate

Sweden is needed to overcome the deadly tuberculosis

Every year, 9 million people get tuberculosis. During the same period, 1,5 million people die from the disease. Research on new diagnostic methods and drugs is not a priority. Large pharmaceutical companies tend to pull out instead of investing more. Sweden has all the prerequisites to become the strong voice needed to prioritize the fight against tuberculosis. That is the opinion of Judith Bruchfeld, Gunilla Källenius, Knut Lönnroth, Olle Stendahl, Claes Ånstrand and Johan Mast.

Tuberculosis is a dominant global health problem, especially among the poorest in poor countries. Annually, 9 million people fall ill and 1,5 million die; there are more than 4000 deaths a day. The disease does not only cause suffering and death. It is also a great social and economic burden for the individual, family and society. Tuberculosis is both a result of and a cause of poverty.

In a year, the World Health Organization's millennium goals for tuberculosis will be met. Some successes can be noted. The goal of stopping the increase in new cases of tuberculosis seems to be succeeding. But the decline is unfortunately much slower than hoped. At the same time, there is a development towards increasingly widespread drug resistance and a growing proportion of difficult-to-treat or incurable tuberculosis.

If we do not get rid of the tuberculosis epidemic as soon as possible, there is a risk that the spread we now see of resistant bacteria will make it impossible to eliminate the disease.

The World Health Organization has set a new goal for the global tuberculosis epidemic to last until 2035. The goal has been set with full knowledge that it will not succeed without three fundamental components: better health care, poverty reduction and research leading to new more effective methods for diagnosis, treatment and prevention.

Sweden has some of the lowest tuberculosis rates in the world, but the trend is going in the wrong direction. Over the past 10 years, tuberculosis rates have increased by 40%. As in other rich countries, most cases of tuberculosis are imported cases. We must therefore work together in both countries with a high and low incidence of tuberculosis to fight the disease.

The need for collaboration that stimulates and finances more and better research is urgent. We need new, better and faster methods for making diagnoses. The longer a patient with infectious tuberculosis goes undetected, the more time there is to be infected. We need new effective medicines. And most of all, we need a new and effective vaccine. Finally, we need research to develop better ways to deliver health care and social support to those who need it most.

Despite great needs, however, tuberculosis research has been severely underfunded for many years. The biggest shortcoming is the lack of investment in new diagnostic methods and drugs. Large pharmaceutical companies, tend to pull out instead of investing more.

Right now, the World Health Organization and Karolinska Institutet, together with the Ministry for Foreign Affairs, are gathering the world's most prominent tuberculosis researchers and decision-makers to discuss how available research resources can be used more efficiently, and how more money can be mobilized. It is difficult to create good markets for products that are needed most by those who have the least.

What can Sweden do to contribute to words becoming action and results?

Sweden developed one of the very first drugs for tuberculosis. Swedish researchers have successfully increased knowledge about diseases in poor countries, and developed tools to combat the infectious diseases of poverty. We have strong expertise in basic research, health system research and social medical research. The Swedish support to the Global Fund against AIDS, tuberculosis and malaria as well as to the WHO is extensive and important.

But Sweden can do better. For the world to succeed in the fight for a tuberculosis-free world, we must set clear goals and push the issue forward. New forms of financing are needed where the future price of medicines is disconnected from the cost of research and development. Needs should govern, not who can pay. Public funds or guarantees are necessary to stimulate basic research and to steer the interests of industry in the right direction. New collaborations must be created. Much more research and development aid must be invested.

In the coming years, a strong voice in the world is needed to give clearer priority to tuberculosis in global development cooperation and research funding. Sweden has all the prerequisites to become that voice.

What does the Minister for Development Aid say?

This is a debate article. The author is responsible for analysis and opinions in the text.

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