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Renewing the Fight Against TB and AIDS T he opportunity in our lifetime

Renewing the Fight Against TB and AIDS T he opportunity in our lifetime . Stop TB Partnership 22 nd July, 2014 | AIDS 2014 presentation | Melbourne, Australia. TB and HIV - One Disease?. Two Epidemics, One Fight, …One Disease? . 4.4 MILLION.

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Renewing the Fight Against TB and AIDS T he opportunity in our lifetime

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  1. Renewing the Fight Against TB and AIDS The opportunity in our lifetime Stop TB Partnership 22nd July, 2014 | AIDS 2014 presentation | Melbourne, Australia

  2. TB and HIV - One Disease? Two Epidemics, One Fight, …One Disease? 4.4 MILLION

  3. Save One Million Lives – Launched in 2011 by UNAIDS, WHO, Stop TB • Testing for HIV and TB should be provided every three years in places where both diseases are prevalent. • Prompt TB treatment needs to be provided to every person living with HIV with active TB - or else treatment to prevent TB. • HIV and TB treatment must be accessible and of good quality so that people living with HIV are cured of TB. • ART should be started early since people living with HIV are far less likely to become ill with and die of TB if they begin ART before their immune systems begin serious decline

  4. TB-HIV The Numbers 1.1m New HIV Positive TB Cases in 2012 13% Of PLWHA screened for TB in 2012 46% People with TB Tested for HIV in 2010

  5. the burden TB incidence target global 125 107 92 79 68 58 50 43 37 32 28 24 20 18 15 13 11 10 9 8 7 6 5 4 10 / 100k / 100k year 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090 2100 2110 2120 2130 2140 2150 2160 2170 2180 2190 2200 2210 2230 2250 2270 2290

  6. 8.6 MILLION estimated TB cases the burden MDR-TB 450,000 estimated new cases • 77,000 MDR-TB cases diagnosed and on treatment 1.3 MILLION XDR 5.7 MILLION new cases diagnosed and treated 45, 000 （10%）estimated cases of XDR

  7. we must act now to end TB in our lifetimes

  8. the road to 10 / 100,000 TB incidence • Scale-up to 100% coverage of proven interventions • Prioritized focus on vulnerable groups- including women and children • Integration within country-region context and system • New tools today 125 10 2180 2035

  9. What it takes Know your epidemics and hot spots Good, reliable data with a focus on key affected groups and vulnerable Prioritize and invest strategically Walk away from everything everywhere and "vertical approaches" Work in partnership Involvement and engagement of all stakeholders throughout the entire processes.

  10. What we struggle with Need for bold and ambitious targets based on data but pushing boundaries Need for scale up plans – no more "pilot projects" Walk away from passive approaches and go towards active and patient/people centered work Integrated approaches with efficiency savings Work to fit in the overall country health system and plans

  11. What we need more of Science of Delivery on the Ground – Know How Civil Society, communities and country based activists for TB Increased funding for high-impact programs and R&D Evolving global one size fits all approaches to more regional and country focused solutions

  12. Discussion • What are the barriers to better integration of the TB-HIV response – technical barriers, global and local advocacy, integrated delivery and testing? • What are the barriers to accelerated scale up of testing and treatment? • What else do we need more of? What are some of the challenges you face in your work?

  13. Which came first?

  14. Goal: End the global tuberculosis epidemic • 2035 Milstones: • 95% reduction in tuberculosis deaths (2015 baseline) • 90% reduction in tuberculosis incidence rate (2015 baseline) • No affected families facing catastrophic costs due to tuberculosis WHO Post 2015 Strategy

  15. Rhetoric to Action: The Global Plan for TB • First Global Plan to Stop TB: 2001-2005 • A ten-year Global Plan: 2006-2015 • 5-year Global Plan: 2011-2015 Global Plan for 2016-2020 2001-2005 2006-2010 2011-2015 2016-2020 The next 5-year Global Plan: 2016-2020

  16. Components of the 2011-2015 Plan • Part 1: Implementation • DOTS expansion and enhancement • Drug-resistant TB • TB/HIV • Laboratory strengthening • Part 2: Research and Development • Fundamental research • New diagnostics • New drugs • New vaccines • Operational Research

  17. The Challenge Projections to 2035 compared with current trends

  18. The Purpose • The Global Plan to Stop TB 2016 – 2020 will: • Show what it takes to set the world on the right track to reach the goals set in the WHO post-2015 Global TB Strategy • It will describe the activities needed in different regions of the world in order to “bend the curve” of TB incidence and mortality • It will provide an estimate of costs

  19. Timeline

  20. Discussion • What should our country, regional, and global priorities be in the 2016-2020 Global Plan for TB? • How can the next Global Plan incentivize TB-HIV integration?

  21. Why doesTB need an identity?

  22. Identityisnota… LogoSlogan Campaign Buta lensforhowwe… Think Act Communicate

  23. We need a paradigm shift inthe way wethink and speak about TB. Stakeholder interview

  24. This is not a rebranding exercise. It’s about creating a movement that changes attitudes andbehaviours. Stakeholder interview

  25. From 6

  26. To 7

  27. Project Timeline Feb Mar Apr May June July Aug Sept Oct Nov Phase 1: Discovery + Analysis Phase 2: Strategic Platform Phase 3: Messaging Guidelines Phase 4:Visual Identity Phase 5: Validation Research Phase 6:Guidelines Phase 7: Implementation

  28. We need to makeTB everyone’s problem. Stakeholder interview

  29. There needs to be awillingness to accept the way we’ve beendoing things [around messaging] hasn’t worked. Stakeholder interview

  30. TB isn’t speaking to theeveryday person Language and terminology is very clinical Doesn’t feel accessible to the average person Stigmatises people living with TB Doesn’t motivate the “incidence” “prevalence” “cases” “suspects” “detection” advocate or donor “default” “MDR-TB” “XDR-TB”

  31. TB has been hereforever and it hasn’t changed. It’s time to makeit fit for the 21st century. Stakeholder interview

  32. We need to make it unacceptable that people are dying of TB. People should be outraged by the factwe have a diseasethat is curable. Stakeholder interviews

  33. Inthepoliticalspherepeoplewantapractical,positivewayforward.TBneedstofeellikeit’sawinningrace.Inthepoliticalspherepeoplewantapractical,positivewayforward.TBneedstofeellikeit’sawinningrace. Politicianswanttobe associatedwithacause thatworks. Policy Maker interviews

  34. The insights TB is trapped in the medical world A scientific approach doesn’t engage hearts and minds Complacency within the TB community isstifling progress TB as a global issue is remote and lacks urgency TB has played the unconfident underdog for too long

  35. The opportunities Position TB as a social issue Create a human connection Be entrepreneurial with TB Make impact personal Tell a hopeful + heroic story

  36. The identity of TB must capture twocore thoughts… Proximity Humanity

  37. The concept: Closer TB is closer than we think. The solution is closer than we imagine.The fight is more urgent than ever before. Get closer to TB. Disclaimer This is not finalised – we are sharing it as an initial concept for discussion

  38. The principles: Intimacy:an emotional connection that makes TB real and personal Unity: understanding that TB is everyone’s problem to solve Empowerment:unleashing latent power in others to beat TB Progress:fighting stigma, raising awareness and creating results

  39. The asks: Confront stigmaby getting closer together and talking about TB’s truth Create urgencyby demonstrating theneed for global, collective action Activate supportby empowering eachother with the tools and inspiration Push for progressby working closer together to create change where it matters

  40. Thestory: TB is closer than we think. Getting closer to the reality of TB, the survivors and supporters, brings you harsh truth; a deplorable kind of injustice. Uniting our collective strength gets us closer to resolution. We canconfront stigma, create urgency, activate support and push forprogress. With advocacy, perseverance and passion we can get closer toreaching the 3 million that need treatment, closer to stronger communities and closer to life that goes on living. Get closer to what TB is. Humanity's problem to solve. For our children. For our future. For all of us. We deserve to live without fear. Get closerto a world free of TB.

  41. VisualIdentity Options for the visual identity are being prepared, and different ideas will be tested across the global health community. Only after a wide consultation will the identity be ready to be launched into the world.

  42. ofTB Theworldisbecom‹iJgsmallerandweareclosertoeachotherthaneverbefore. Explorethe truthofTB. 18OCTOBER -20DECEMBER2014 FREEFORMEMBERS

  43. TherealstoriesofTBSurvivors. Don'tletbarriersstandinyourway.Getclosertothetruth. GetclosertowhatTBmeans,howitworksandhowtofight back. Showing 1-50of 1221stories Mostrecent Gettingthesupport IneededtobeatTB Protectyourself fromTB DangersofTBinschool Livingwith latentTB

  44. 5

  45. 6

  46. Skypestories

  47. Thank you.

  48. Discussion What was your initial reaction? What works? What could be better? Would the TB Community unite behind it? 81

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