Building Global Awareness of the
Impact of Tuberculosis
The Ripple Effect of TB
Rachel Azanleko-Akouete (l-r), Amanda Beals, Thokozile Phiri-NKhoma
and Scott Berry
One reason it hasn’t been eradicated is that cost-effective technology that can be effective where the cases are hasn’t been developed. But a Madison firm is
working on that.

“By focusing on diagnostics, we really see that as one of the missing links in this puzzle,” said Scott Berry, chief scientific officer at Salus Discovery and an
associate research scientist at the University of Wisconsin. “There are a lot of diagnostics available. But a lot of them are very expensive and very complicated to
use and really not suited for the places where they are most needed. And so, with funding from the Bill & Melinda Gates Foundation, we’ve got a project going on.
We’ve been at it for just about a year with another two years to go. Our goal is to develop a much simpler, low-cost test. If you think of a home pregnancy test, that’s
really what we have in mind. With current testing, they have wonderful molecular methods to amplify the DNA of tuberculosis and all of this, but they are expensive
and often not suitable for the most rural locations. We really want to make a very low-cost test in the vicinity of two dollars, a test like a home-pregnancy test that is
very basic. The idea is you would get a sample cup, fill it with urine and the test would happen and give you a read-out much like a home pregnancy test. We’re
hoping to move the tests from the most advanced clinics, the most advanced labs out into the villages, out into the places where they are most needed where we
envision these tests will be run by nurses and community health care workers and the people who can really provide the first line of contact with the patient. To that
end, we’ve been developing really an international consortium of engineers like myself, but also clinical partners, community health care worker partners as well
as NGOs to really take a holistic approach to this. Solving the engineering problem is only one part of the solution. Getting buy-in from the end users, making sure
that this is really the test that they need.”

Another important factor in the eradication of TB is generating the political will and resources to eradicate it.

“If we don’t focus on upstream prevention, we cannot end TB,” Azanleko-Akouete said. “We have to really think about it globally. It’s affecting a lot of people in
developing countries. We can’t just forget about them because they are living in poverty. It’s a human rights issue. They deserve treatment for TB. We have the
medication and the resources. Why are we not talking about it? Why isn’t it a priority? We really have to make TB a priority. We have the resources to eradicate this
disease. We really want to focus on building the political will so that we can fight and eradicate this disease.”

Phiri-NKhoma also emphasized that the solution is global.

“A lot of countries are contributing, but it’s also worth noting that the U.S. government has been a leading donor to the global fund,” Phiri-NKhoma said. “And I think it
is good to bring this up. Let’s celebrate the U.S. as a major contributor. We need to celebrate the contributions which have led to the global community contributing.
But the message right now is we have come a long way and we have to sustain the gains and actually male more progress toward ending the disease. The global
fund provides the treatment for free in most of our countries. But there is a gap. Eighty-five percent of all global funding for TB comes from the countries themselves.
That tells you there is a gap. If we sustain and increase the funding, that will make sure that contribution is matched towards the end of the disease. That can be
done with that political will.”
Part 2 of 2
By Jonathan Gramling

As a public health nurse, Rachel Azanleko-Akouete is well aware of the impact of
tuberculosis or TB. While many may think that TB was eradicated long ago, according to
the CDC, 470 people in the United States died from TB in 2015.

And while the world community has the capacity to eradicate TB, it is still a disease
impacting hundreds of thousands worldwide.

“Can you imagine when we have the science, when we have the drugs, when we know
that the disease is preventable and is curable and is treatable, why should we be losing
people, 4,600 people every day,” asked Thokozile Phiri-NKhoma, executive director of
Facilitators of Community Transformation in Malawi, Africa. “Why aren’t we talking about
it?”
The opportunity to develop that political will is coming up this fall.

We want our members of Congress to be leaders on this issue,” said Amanda Beale,
a member of RESULTS. “We want them to make this a priority. Just like a lot of other
issues we have going on, we don’t want this to be an issue that gets pushed aside
this year. We need to increase resources for diagnosis, for treatment and health
systems. But the big thing is this year the global community is really rallying around
this issue. We actually think that if the U.S. shows leadership, we can change the
trajectory of TB. That’s where other world leaders are going. But the UN is going to be
convening a meeting in September to bring people together. What we really need to
do is have our leaders step up and be a part of that to increase our resources and
our focus on TB.”

And if the U.S. doesn’t full engage with this UN effort, it could see the leadership in
the effort to eradicate TB fall onto the shoulders of other up and coming developing
countries.

“In India, Prime Minister Modi came forward and made a very ambitious declaration
of ending TB in India by 2025,” Phiri-NKhoma said. “The world organization’s target is
ending the disease by 2030. A quarter of the people who bear TB live in India. To
have a political leader at that level declare the end of TB is just amazing. We want to
see a lot of political leaders make a similar declaration. Even with the fact that the U.
S. has taken leadership on most global disease management initiatives, we want the
U.S. to step up with this disease and say, ‘We’re taking on this commitment as well
to end TB by 2025.’”

“We have the solutions to these problems,” Berry emphasized. “It’s just a matter of
getting the treatments to the right people.”

The window of opportunity has opened for the eradication of TB with the convening of
high-level meetings this fall at the UN offices in New York. The question is, will the
United States and other developed countries, as well as the developing countries
most impacted by the disease, step up to the plate and seize the moment to end this
disease that destroys the lives of families and hinders economic development in
some parts of Africa? We shall see.