Global Health Diplomacy is Essential to Ending Tuberculosis

In March 2019, The Lancet published a series of articles on tuberculosis (TB), known as The Lancet Commission on TB. One of these articles underscored how global health diplomacy will be essential to fighting the global epidemic. According to the article’s authors, United Nations Special Envoy for Tuberculosis Eric Goosby and the University of California-San Francisco’s Dr. Michael Reid and Dr. Sebastian Kevany, “Global health diplomacy is crucially important in ensuring sustained political engagement and in addressing the multisectoral challenges that have hampered global efforts to control tuberculosis over the past century.”

In their view, global health diplomacy provides “a framework that can motivate innovative multilateral cooperation and investment in global health, ensuring tuberculosis is prioritized in the context of national security, trade, climate change and migration policies.” The authors also point out that global health diplomacy ensures that TB remains a priority in high-burden countries as the world moves away from disease-focused policies to universal health coverage.

According to a report to the Secretary-General of the United Nations (UN) released on April 30, there is a sense of urgency for TB-focused health diplomacy. In this report, the UN Interagency Coordination Group on Antimicrobial Resistance stated, “[u]nless the world acts urgently, antimicrobial resistance will have a disastrous impact within a generation.” The Interagency Coordination Group on Antimicrobial Resistance explained that drug-resistant TB already causes 230,000 deaths per year but that number “could increase to 10 million deaths globally per year by 2050 under the most alarming scenario if no action is taken.” Another report released this month by The Economist Intelligence Unit echoed the urgency and projected that drug-resistant TB will cost the global economy $17 trillion by 2050 if it is not adequately addressed now.

In their article, Goosby, Reid and Kevany point to two specific areas where global health diplomacy will be used to meet this urgent need and facilitate efforts to end TB: increasing access to TB medicines, particularly for drug-resistant TB, and ensuring progress is made through the UN Sustainable Development Goals.

In a world of many competing priorities, global health diplomacy can help focus attention and resources on TB, the leading infectious cause of death that will only get worse without the sustained, combined efforts of diplomacy and health professionals. 

To begin, Goosby, Reid and Kevany highlight how global health diplomacy can shape markets for drug-resistant TB drugs and help high-burden countries obtain these medicines by negotiating lower prices with pharmaceutical companies and leveraging donor funding. In an earlier post for this blog, I described how MSF’s Access Campaign employs a range of public diplomacy tools—public speeches, op-eds, events, reports, social media campaigns and press releases—to inform the public in countries severely affected by tuberculosis as well as in less affected countries like the United States and Canada about the need for TB medicines. MSF has been successful in not only helping countries to access lower priced medicines, but also enabling the world to hear the experiences of TB patients who would otherwise be overshadowed in the crowded global health landscape.

Similarly, the article described how the “UN Sustainable Development Goals (SDGs) highlight the importance of the broader multisectoral agenda to end TB…[which] is predicated on improving air pollution, regulating certain industries, and optimizing urban development.” Specifically, “Global health diplomacy is essential to ensuring that such links are made, and that partnerships that include stakeholders from the relevant sectors are forged.”

Public diplomacy experts have also recognized the importance of public diplomacy in achieving the SDGs, including James Pamment, who has said that the SDGs present the public diplomacy opportunity of a generation. Writing in the CPD blog in 2015, Pamment stated that “the SDGs will need public diplomacy to succeed, and that those of us involved in the PD community need to take on this challenge with the utmost urgency.” According to Pamment, “the SDGs will struggle unless they are supported by innovative and bold public diplomacy techniques, and PD itself can be galvanized in the attempt to meet this challenge.” His words now hold true for efforts to end TB, which require the best that public diplomacy can offer to be successful.

On May 20-28, 2019, the 72^nd World Health Assembly is being held in Geneva, Switzerland. At this time, UN member states and civil society will come together to discuss an agenda filled with the most pressing topics in global health, including TB. During the World Health Assembly, Director-General Dr. Tedros Adhanom Ghebreyesus plans to highlight the need “to strengthen collaboration between all stakeholders to end the tuberculosis epidemic and implementing the political declaration, with Member States and relevant partners, with a special focus on acceleration of efforts, strengthening country capacity and multisectoral response.”

On May 14, Dr. Ghebreyesus attended the launch of the Declaration of the Rights of People Affected by TB, which aims to empower people affected by TB to know and claim their human rights. According to the Stop TB Partnership, what a rights-based response entails is still largely unknown or misunderstood. The launch event was held in collaboration with the Stop TB Partnership, which is using tried and true public diplomacy tools and techniques to end TB. One example of Stop TB’s past public diplomacy work is the health ministers’ of Lesotho, South Africa, and Swaziland visit to Washington, D.C. in 2011, which included a media campaign designed to generate awareness among the American public about the heavy toll the disease has taken on their countries and to underline the crucial role U.S. support plays in the efforts to contain the epidemic. Other examples include Stop TB’s use of social media for the “Step Up for TB” campaign and World TB Day.  

Ultimately, global health diplomacy—using innovative and effective tools of public diplomacy—will help the international community to end TB. In a world of many competing priorities, global health diplomacy can help focus attention and resources on TB, the leading infectious cause of death that will only get worse without the sustained, combined efforts of diplomacy and health professionals. 

Note from the CPD Blog Manager: The opinions represented here are the author's own and do not reflect the views of her employer.

Photo by U.S. Mission Geneva/ Eric Bridiers | CC BY-ND 2.0 | Image shows a scene from the 67th World Health Assembly (WHA)