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1 / 4 / 6 x 24

A Campaign to Rally Energy, Funding, and Political Will to End TB

Tuberculosis (TB) is one of the world’s deadliest infectious diseases, but has long been neglected by governments, funders and global health actors. For more than a half century, we’ve been fighting TB with the same outdated resources, strategies and long, toxic courses of treatment that left patients with lasting side effects.

Thanks to decades of investment in scientific research, we now have newer, safer, and more effective regimens – but very few people around the world have access to them. The 1/4/6×24 Campaign aims to change that. The Campaign’s name comes from its central demand: that countries and other duty bearers take action to implement the shortest available regimens – one month or once-weekly for TB prevention, four months for drug-sensitive TB, and six months for drug-resistant TB — by the end of 2024.

1 = One-month and once-weekly TB preventive treatments, 1HP and 3HP (one month of daily, or three months of weekly isoniazid and rifapentine).

4 = Four-month treatment regimens for drug-sensitive TB, 4HPMZ for adults and adolescents (four months of isoniazid, rifapentine, and moxifloxacin with pyrazinamide for the first two months) and 4HRZ[E] for children with non-severe TB (four months of isoniazid, rifampicin with pyrazinamide, and in certain circumstances with ethambutol, for the first two months).

6 = Six-month treatment regimens for drug-resistant TB, 6BPaL[M] (six months of bedaquiline, pretomanid, linezolid, with moxifloxacin depending on drug-susceptibility).

x 24 = by the end of 2024!

The 1/4/6×24 Campaign draws inspiration from the legacy of the late Partners in Health (PIH) co-founder Dr. Paul Farmer, who stressed the so-called “five S’s” that countries must have in place to deliver equitable care to the poorest people: stuff, staff, space, systems and support. 1/4/6×24 also nods toward the WHO and UNAIDS 3×5 Initiative, which aspired to put 3 million people living with HIV in low- and middle-income countries on ART by 2005 – a step towards the ultimate goal of universal access to HIV treatment and prevention. Similarly, 1/4/6×24 serves as a collective demand to build the momentum we need to course correct the global fight to end TB.

Check back here for additional campaign materials and updates, and information on how to get involved!

CAMPAIGN RESOURCES

    • Statement about the 1/4/6×24 Campaign launch event held at the 2022 International AIDS Society Conference in Montreal, Canada (July 31, 2022).
    • Global List of Asks and Actors  for the 1/4/6×24 Campaign, outlining advocates’ expectations and laying out key action steps and research priorities.
    • Brochure for general readers explaining 1/4/6×24 and why it matters.
    • Press release about the 1/4/6×24 Campaign Call to Action at the USAID TB Symposium in Washington, D.C. (October 27, 2022)
    • Template Advocacy Letter to support community and civil society organizations to engage national policy makers on the need to update national guidelines and mobilize resources to ensure the 5 S’s necessary for 1/4/6×24
    • November, 2022 TAGline article: Introducing 1/4/6×24: A Campaign That Draws Inspiration from the Past to Change the Trajectory of the Future Fight to End Tuberculosis
    • Community Campaign Training Materials to support national workshops to train civil society and community allies on 1/4/6×24 as a basis for national campaign advocacy strategy development.
    • Nature Medicine Correspondence detailing the 1/4/6×24 Campaign and actions needed to scale up implementation of the shorter, safer 1/4/6 regimens (January 10, 2023).
    • GFAN Advocacy Guides to 1/4/6×24 to support advocacy for the prioritization and inclusion of 1/4/6 regimens in national strategic plans and Global Fund funding requests.
    • Aidspan article with information and links to resources to support advocates to push for prioritization and inclusion of 1/4/6 regimens in national strategic plans and Global Fund funding requests (March 8, 2023).
    • How-to Guide: Make your own pill burden display for in-person events to show the dramatic reduction in the number of pills one needs to complete treatment with 1/4/6 regimens compared to the older, longer, and more toxic regimens.
    • World TB Day press release detailing 1/4/6×24 Campaign Coalition demands and why 1/4/6×24 is needed to get back on track to ending TB by 2030 (March 20, 2023).
    • World TB Day toolkit with links to key 1/4/6×24 resources and a series of sample social media posts and graphics to push for 1/4/6×24 leading up to World TB Day (March 24, 2023) and beyond.
    • 1/4/6×24 Videos featuring TB survivors from around the globe sharing their experiences and challenges taking the longer regimens and explaining why scaling up access to the shorter, safer regimens for TB prevention and treatment matters.
    • Statement from the 1/4/6×24 Coalition welcoming India’s rejection of Johnson & Johnson’s patent evergreening tactic for bedaquiline (March 28, 2023).
    • IJTLD Editorial highlighting Ukraine’s efforts to successfully adopt and implement the shorter, safer 1/4/6 regimens in the midst of a devasting war.
    • Lancet Microbe Comment detailing the diagnostic tools, strategies, and actions necessary to close diagnostic gaps for TB and DR-TB and achieve 1/4/6×24 (July 31, 2023).
    • 1/4/6×24 Campaign Statement calling on country governments to go beyond the UN High Level Meeting political declaration on TB to deliver the funding necessary to scale up access to the 1/4/6 regimens and supportive diagnostics by the end of 2024 (September 19, 2023).
    • Joint Statement by 1/4/6×24 Coalition Members on the role of community activism in delivering recent price reductions of lifesaving tools bedaquiline, 3HP, and GeneXpert TB tests, and what must still be done to reduce prices and increase access to 1/4/6 regimens and supportive diagnostics (November 7, 2023).
    • 1/4/6×24 Campaign One-Pager highlighting the recent price reductions of 1/4/6 medicines and supportive diagnostics and the opportunity to take advantage of the Global Fund grant cycle (GC7) to increase uptake of the 1/4/6 regimens — especially the “4” (November 7, 2023).
    • Getting Better Faster: Delivering on the Promise of New TB Treatments, a report from the 1/4/6×24 Campaign assessing progress and gaps in scaling up the 1/4/6 regimens and detailing concrete actions country governments and global health actors should take to meet the Campaign goals by the end of 2024. (March 21, 2024)
    • 1/4/6×24 Campaign report launch press release highlighting the findings and recommendations of the 1/4/6×24 Campaign report and drawing attention to the slow progress scaling up the four-month HPMZ regimen for drug-susceptible TB in adults and how country governments and global health actors should address this. (March 22, 2024)
    • 1/4/6×24 Campaign report launch webinar recording + slides featuring the report authors, members of the 1/4/6×24 Campaign Coalition, and partners discussing the findings and recommendations of the report, the importance of centering the needs of affected communities in the TB response, and approaches countries can take to improve access to the 1/4/6 regimens. (March 27, 2024)
    • 1/4/6×24 EECA Region webinar recording, hosted by TB Europe Coalition and ITPC-EECA, detailing 1/4/6×24 Campaign successes and challenges in the Eastern European and Central Asian region and discussing experiences with 1/4/6 regimens and policy translation in the region, including Azerbaijan’s rollout of 4HPMZ and Ukraine’s approach to rapid policy adoption. Here’s a link to the webinar recording in Russian. (May 14, 2024)

CAMPAIGN ACTIVITIES

CAMPAIGN COMMITMENTS

This campaign speaks to governments, normative and regulatory agencies, multilateral agencies, bilateral and other donors, clinicians, nurses, community health workers, TB survivors, civil society, activists, and community groups, and makes specific asks of national governments, international donors, pharmaceutical companies, and other people and institutions in positions of power to affect the course of the TB response. Here we share the commitments on 1/4/6×24 that have been made to date:


This work is led by the 1/4/6×24 Campaign Coalition, an international network of TB survivors, researchers, clinicians, activists, and civil society professionals who advocate for communities affected by TB. Their institutional affiliations include:

Treatment Action Group (TAG)
Partners In Health (PIH)
Médecins Sans Frontières (MSF)
Global Coalition of TB Advocates (GCTA)
Treatment Action Campaign (TAC)
Global TB Community Advisory Board (TB CAB)
Stop TB Partnership
Survivors Against TB
Results Canada
The Sentinel Project Against Pediatric Drug-Resistant TB
We Are TB
TBPPM Learning Network
Asia Pacific Counsel of AIDS Service Organizations (APCASO)
African Coalition on TB (ACT)
TB Europe Coalition (TBEC)
Lean on Me Foundation
O’Neill Institute for National and Global Health Law at Georgetown University
TB Women Global
Wote Youth Development Projects
Zambia Association for Prevention of HIV and TB (ZAPHIT)
SMART4TB Consortium

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