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Heads of State met in New York on 26 September 2018 at the United Nations General Assembly’s first ever High-Level Meeting on TB, to accelerate efforts to #EndTB and reach all affected people with prevention and care. The theme of the meeting was “United to end tuberculosis: an urgent global response to a global epidemic.”
The High-Level Meeting resulted in Heads of State endorsing an ambitious Political Declaration on TB to strengthen action and investments to end TB, saving millions of lives.
UNDP recognizes that ending TB requires an enabling framework that protects and promotes human rights and gender equality. The Lancet Commission on TB similarly identified this recommendation, in identifying global actions necessary to #EndTB.
Key populations most at risk of TB infection are also often those who live in conditions of poverty, social inequality and marginalization. Impoverished socioeconomic circumstances place key populations at greater risk of TB infection and impair their ability to realize their health rights to access TB prevention, treatment, care and support services voluntarily and without discrimination.
Project in Peru shows that social determinants are key to end TB
TB is often referred to as “a disease of the poor”. The Innovative Socio-Economic Interventions Against Tuberculosis (ISIAT) project addressed this in the impoverished communities of Callao, Peru, by offering psychosocial and economic support to enhance access to TB care and increase prevention and cure.Read more...
“The most acceptable, feasible components of ISIAT were then combined into a standardised intervention that consisted of integrated social support (household visits and “TB Clubs” involving peer-led mutual support groups) and economic support (conditional cash transfers), evaluated in the Household-Randomised Evaluation of a Socioeconomic Intervention to Prevent Tuberculosis (HRESIPT). HRESIPT showed that patients offered the intervention were more likely to achieve treatment success, their contacts more likely to initiate preventive therapy, and the household less likely to incur catastrophic costs.” i
UNDP supports countries to address critical enablers, such as poverty, discrimination and gender inequality, to promote the health and development of all people and achieve the Sustainable Development Goals. It is critical that the High-Level Meeting and subsequent Declaration respond to the Key Ask 2—transforming the TB response to be equitable, rights-based and people-centred i—by placing human rights and gender equality at the centre of global efforts to end TB.
Results achieved through the UNDP - Global Fund partnership
TTB is amongst the top ten causes of mortality worldwide, killing 1.7 million people in 2016, and is a leading killer of HIV-positive people (40% of HIV deaths were due to TB in 2016). UNDP, working closely with national governments and civil society organizations, has provided TB treatment for 874,000 people and for 19,300 people diagnosed with multi-drug resistant TB. In 2018, UNDP was currently Principal Recipient for Global Fund tuberculosis grants in Afghanistan, Belize, Bolivia (Plurinational State) i, Burundi, Djibouti, Kyrgyzstan, Multicountry Western Pacific, Panama, São Tomé and Príncipe, South Sudan, Sudan, Turkmenistan and Zimbabwe.
16 countries with a treatment success rate for TB over 80%
8 countries have seen TB incidence decrease by a third
10 countries where TB related mortality has decreased by more than a third
Large decreases in TB related mortality (per 100,000 population)
Source: World Health Organization
From TB patient to a health worker
Although TB is still prevalent in some communities in Afghanistan, it is particularly widespread among internally displaced persons (IDPs) and refugees returning from neighbouring countries, there being three times as many TB cases among IDPs as in the general population. The deteriorating security situation in Afghanistan and ongoing repatriation of Afghan refugees is further exacerbating the need for healthcare, including TB.Read more...
To respond to this, the UNDP-managed Global Fund programme, in close coordination with the Ministry of Public Health, implements projects to detect and treat TB cases.
Twenty-eight-year-old Muhibullah is a TB survivor who has become a health worker after being cured of the illness. Despite difficulties such as unemployment and insecurity, Muhibullah was working hard to support his family. But one morning he awoke with a high fever and a constant cough. He was subsequently diagnosed with pulmonary tuberculosis, but after six months of persistent treatment, he was cured.
After attending a three-day training on general tuberculosis supported by the Global Fund project, Muhibullah was recruited as the TB focal point and health-worker in Chamtala 2 camp for IDPs. He is now an active member of the TB association and participates in TB intervention programmes. In September, 2018 in Chamtala 2, Mohibullah has referred 36 persons to be evaluated for TB to the Basic Health Center (BHC), two of whom have been diagnosed with TB.
Djibouti: Finding the “missing“ cases of TB
Djibouti hosts more than 27,000 refugees from nearby Somalia, Ethiopia, and Eritrea, equivalent to roughly 3% of its population. With one of the highest densities of refugees in the world, crowded camps create a fertile breeding ground for the transmission of TB. To limit the spread of the disease and ensure no one is left behind, the Government of Djibouti, in partnership with UNDP, UNHCR and the Global Fund, is working to bring diagnosis and treatment facilities into camps, reduce stigma and to stop TB in its tracks.