TO: Dr. Ricardo Barros, Minister of Health of Brazil

Dr. Li Bin, Minister of the National Health and Family Planning Commission of the People’s Republic of China

Dr. Aaron Motsoaledi, Minister of Health of South Africa

Dr. Shri Jagat Prakash Nadda, Minister of Health and Family Welfare of India

Dr. Veronika Skvortsova, Minister of Health of the Russian Federation

15 November 2016

Petition to BRICS countries to triple funding for TB R&D to improve TB/AIDS and AMR response

Dear Honorable Ministers of Health from the BRICS Nations,

On the occasion of the 15-16 November 2016 BRICS (Brazil, Russia, India, China, and South Africa) workshops on TB/AIDS and Anti-Microbial Resistance (AMR) in Ahmadabad and Jaipur, respectively, and in anticipation of the 6th Meeting of the BRICS Health Ministers in New Delhi on 16 December 2016, we petition you to commit BRICS countries to tripling funding for tuberculosis (TB) research and development (R&D).

BRICS countries are home to nearly half of all the world’s new TB cases and deaths.[1] Three BRICS countries—India, China, and the Russian Federation—account for nearly half of the burden of drug-resistant TB (DR-TB), a form of TB that is more difficult to diagnose and treat with existing medications. We applaud the 2015 Moscow Declaration of the BRICS Ministers of Health in which you recognized the tremendous toll TB takes on your citizens and on the world, and resolved to continue collaboration toward TB elimination in line with the World Health Organization (WHO) End TB Strategy and the Communiqué of the 4th BRICS Health Ministers’ meeting in New Delhi in 2012.[2] In these statements, you agreed to adopt a cooperation plan at the next BRICS Health Ministers’ meeting and highlighted research on TB vaccines, medicines, and diagnostics as an important area of cooperation.

We urge you to turn this resolve into swift action. The WHO recently announced that the TB epidemic is larger than previously estimated. In 2015, TB caused 10.4 million people to fall sick and killed 1.8 million people, making it the world’s deadliest infectious disease, as well as a major drain on the economies of BRICS nations and other countries.[3] The Review on Antimicrobial Resistance predicts that DR-TB will account for a quarter of the 10 million annual AMR deaths by 2050 unless research into new medicines, tests, and vaccines to prevent, diagnose, and treat TB is accelerated.[4] In 2015, civil society came together for a march in Cape Town, South Africa and called on BRICS countries to triple TB R&D spending.[5]

Yet funding for TB R&D has dropped precipitously, plunging by US$53.4 million last year to a total of $620.6 million.[6] This represents the lowest level of funding for TB research since 2008. In 2015, India contributed $11.1 million, South Africa $3.9 million, and Brazil $1.9 million to TB R&D. China and Russia did not report their TB R&D spending. Together, BRICS countries contributed 42 percent of new TB cases and 38 percent of TB deaths in 2015, but only 4 percent of funding for R&D to prevent them.

Despite receiving only a fraction of the required investment, TB scientists have made several significant advances over the past five years, including new rapid diagnostic tests and better preventive and curative TB therapies. This demonstrates that funding TB R&D is a sound investment that can generate significant returns—whether measured by lives saved or livelihoods safeguarded—against the impoverishing effects of TB. In addition, by investing in TB R&D, countries can strengthen their competitive advantage in science by building up research infrastructure and human talent.

As your summit in New Delhi approaches, we ask that you deepen your resolve to fighting TB by committing to:

• include a TB R&D funding target of tripling your countries’ spending on TB R&D in the cooperation plan you will finalize in December;
• work with your countries’ Ministries of Science and Technology and Ministries of Finance to ensure that TB R&D is fully funded; and
• transparently report annual spending on TB R&D activities.

We look forward to BRICS leadership in ensuring full funding for R&D to end TB.

Sincerely,

Aaron Oxley, RESULTS UK, United Kingdom

Abou Mere, Kripa Foundation Nagaland, India

Aghasi Vardanyan, Armenia

AIDS and Rights Alliance for Southern Africa (ARASA), AIDS and Rights Alliance for Southern Africa (ARASA), Namibia

AIDS-Free World, Canada/US

Ajay Kumar Patra, KNP+, Odisha, India

Akho Thingo, Social Activist, India

Alberto Colorado, USA

Aleemuddin Naveed M, Chest Care Clinic, India

Aline Sampaio Bello, Secretaria Municipal De Saude De Goiania/Goiás, Brazil

Alphayo Wasonga Oluoch, Coalition Of People Fighting HIV/AIDS In Migori, Kenya

Amy Beeson, Philanjalo NGO, South Africa

Ana Balkandjieva, Bulgaria

Ana Luiza Sodré de Aragão Vasconcellos, Brazil

Ana Paula Ferreira Barbosa, SMS São Gonçalo, Brazil

Andre Kipnis, Universidade Federal de Goias, Brazil

Andre Siqueira, Fiocruz, Brazil

Andrea Afanador, USA

Andrea Maciel de Oliveira Rossoni, UFPR / Rede-TB, Brazil

Anelize Baranzeli, Brazil

Armen Vardanyan, MSF France, Mission Armenia, Armenia

Barbara Seaworth, Heartland National TB Center, USA

Benjamin Dzivenu Tsikata, Hope Care Foundation, Ghana

Betina Mendez Alcântara Gabardo, State Secretary of Health – Paraná, Brazil

Bill Linton, United Kingdom

Bobby, IHRN, India

bouteille, France

Braveen Ragunanthan, VCU School of Medicine Medical Student, USA

Brian Citro, International Human Rights Clinic, University of Chicago Law School, USA

Bruna Roberta Toillier, Universidade de Santa Cruz do Sul, Brazil

C, John Jasper, BLOSSOM TRUST, India

C. Robert Horsburgh, Jr., MD, Boston University, USA

Cândida Maria Nogueira Ribeiro, Secretaria Estadual de Saúde de Pernambuco – Programa Controle da Tuberculose, Brazil

Carl Stein, MHS, PAC, USA

Carlos Afanador, USA

Carolina Morán, Socios en Salud Sucursal Perú, Peru

Catalina Navarro, Heartland National TB Center, USA

Chanel Rossouw, TB Proof, South Africa

Christian Okoye, Sommercy Heartfelt Foundation, Nigeria

Christine Seaworth, USA

Claire Waterhouse, South Africa

Clemax C. Sant´Anna, Universidade Federal do Rio de Janeiro, Brazil

Constanza Espada, Universidade Federal do Santa Catarina, Brazil

Crhistinne Gonçalves, Ufgd, Brazil

Dalene von Delft, TB Proof, South Africa

Daniel Augusto Gasparin Bueno Mendes, Universidade Federal de Santa Catarina, Brazil

Danyella Kessea Travassos, Secretaria Estadual de Saúde de Pernambuco, Brazil

Dayse Sanches Guimarães Paiao, Brazil

Debashish Das, India

Dennis Mseu, Malawi Network of Religious Leaders Living with or Personally Affected by HIV and AIDS (MANERELA+), Malawi

Dimitrios Papaventsis, National Reference Lab For Mycobacteria, Athens, Greece

Donna Hope Wegener, NTCA, USA

Douglas B Lowrie, Shanghai Public Health Clinical Center, China

Douglas McNeill, PeterCares House,    USA

Dr Martin Ifeanyichukwu, Nnamdi Azikiwe University, Awka, Nigeria

Dr. Deborah L. Taylor, Columbus Public Health, Ohio, USA

Dr. Ismail Adam Abdilahi, PSR Finland, Somalia

Dr. C.S. Jamunanantha, Ministry of Health, Srilanka

Dr. Rev. Abraham Calleros, PA,DD,HWHP, Natural Wholistic Health & Wellness Research Center, USA

Durwood Wiggins, USA

Edgar E. Gonzalez Kozlova, Universidade Federal de Santa Catarina, Brazil

Edwin Blesch, USA

Elchin Mukhtarli, Saglamliga Khidmat public union, Azerbaijan

Elma de Vries, South Africa

Emiliano Valle, Socios en Salud, USA

Emperor Ubochioma, National Tuberculosis and Leprosy Control Programme, Nigeria

Eric Serxner, USA

Erica Lessem, Treatment Action Group, USA

Etienne Guillard, SOLTHIS, France

Evellyn Chamisa, NZPW+, Zimbabwe

Fabiana Rodrigues Lima, Brazil

Fanny García Velarde, Socios En Salud Sucursal Perú, Peru

Flávia Cardoso, Universidade Federal de Santa Catarina, Brazil

Francisco Rosas, Vivir. Participación, Incidencia y Transparencia, A.C., Mexico

GEHANT, France

Genevieve Warner Learmonth, University of Cape Town and Groote Schuur Hospital, South Africa

Grace Dugan, Partners in Health, Rwanda

Grace Muzanyi, Uganda-Case Research Collaboration/TBTC Site 30 Kampala, Uganda

Guilherme da Costa Garcia, Brics, Brazil

Gulmira Akbarova, Veremsiz Dunya, TB patients’ organization, Azerbaijan

Helen Cox, University of Cape Town, South Africa

Hilary Vansell, Vanderbilt Tuberculosis Center, USA

Infectious Diseases Society of America, USA

Isabela Pezzini Volpato, Hospital Universitário da Grande Dourados, Brazil

Janita Holtzhausen, South Africa

Jennifer Furin, DR-TB STAT, USA

Jerome St-Denis, FIND, Switzerland

Jholerina Timbo, Wings To Transcend Namibia, Namibia

Joanne Winter, United Kingdom

John Nelson, USA

Jonathan Daniels, USA

Jonathan Stillo, TB Europe Coalition, USA

Joyce Alencar santos, Universidade Federal da Grande Dourados, Brazil

Julio Croda, Oswaldo Cruz Foundation, Brazil

Kaitlyn Shaw, DNA Genotek, Canada

Karla Tafur, Socios En Salud, Peru

Karma sgerpa, Federation of drug demand reduction, Nepal

Kataisee Richardson, ICASO, Canada

Kennedy Chungu Palangwa, Zambia Network of Religious Leaders Living with or Personally Affected by HIV and AIDS, Zambia

Kenneth G. Castro, MD, FIDSA, Emory University Rollins School of Public Health, USA

Ketho Angami, ARK foundation, India

Kevin Goetz, USA

Kevin Schwartzman, McGill University, Canada

Khairun, TB CAB, Kenya

Lameck Mpando, Tandanzala Community Arts, Zambia

Leonardo Palumbo, USA

Lindsay Jackson, RN, Public Health Nurse, Department of State Health Services, Livingston Texas, USA

Lindsay McKenna, Treatment Action Group, USA

Lívia Yamashiro, Brazil

Liza Murrison, University of Cincinnati College of Medicine, USA

Lúcia Dias, Brazil

Luciana Nunes, UNIPAMPA, Brazil

Luckyboy Mkhondwane, Treatment Action Campaign, South Africa

Ludmila Cristina do Carmo Tavares, Comitê Mineiro para o Controle Social da Tuberculose, Brazil

Luisa Souza Echeverria, Brazil

Lyn van Rooyen, CABSA, South Africa

Maiara Leite Barberino, Secretaria Estadual de Saúde do estado de Pernambuco, Brazil

Maíra Assunção Bicca, UFSC, Brazil

Mandy Slutsker, ACTION Global Health Advocacy Partnership, USA

Manoj Pardeshi, National Coalition of PLHIV in India, India

Marco Gomes, Canada

Marcus Low, Treatment Action Campaign, South Africa

Margareth Dalcolmo, FIOCrUZ  – Fundação Oswaldo Cruz, Brazil

Maria Alice da Silva Telles, Instituto Adolfo Lutz, Brazil

Maria da Glória Garcia, Brics, Brazil

Maria das Graças Rodrigues de Oliveira, Secretaria Municipal de Saúde de Belo Horizonte, Brazil

Maria Helena Féres Saad, Oswaldo Crus Foundation (FIOCRUZ), Brazil

Maria Margarida da Rocha Fiuza de Melo, Brazil

Mariana Soares Puppin, Rio de Janeiro City Health Department, Brazil

Mario Raviglione, World Health Organization, Switzerland

Marize Teixeira Vitorio, Universidade Federal da Grande Dourados, Brazil

Mark Harrington, Treatment Action Group, USA

Marlucia da Silva Garrido, Programa Estadual De Controle Da Tuberculose/FVS-AM, Brazil

Marshal Sikandangwa, Eastern Provincial Health, Ministry of Health, Zambia

Mary Thomas, USA

Mary Upton, United Kingdom

Maxo Luma, MD, MPH, Partners in Health, Liberia

Mercy Annapoorani, Rainbow TB Forum, India

Messias Villa Mendonça, UFGD, Brazil

Michelle Haas, Denver Metro TB Program, USA

Mike Frick, Treatment Action Group, USA

Milagros Mendoza, Socios en Salud Sucursal Perú, Peru

Mônica Kramer de Noronha Andrade, National Public Health School/Oswaldo Cruz Foundation, Brazil

Mthulisi Ncube, MSF, South Africa

Muhammad Kamran, Meritnews group, Pakistan

Muratet  Liliane, France

Murilo Delgobo, UFSC, Brazil

Natalie Gill-Mensah, Clinton Health Access Initiative, USA

Nicole Menezes de Souza, Brazil

Nii Nortey Hanson-Nortey, Ghana Health Service, Ghana

Nonna Turusbekova, Kyrgyzstan

Nora Engel, Maastricht University, Netherlands

Nune, MSF, Armenia

Ohanna, MSF, Armenia

P. Santhanalakshmi, Paneer HIV Positive Women Trust, India

Pare, MSF, Armenia

Patricia Bartholomay Oliveira, Ministério da Saúde, Brazil

Patricia Cafrune, Brazil

Patrick Phillips, MRC CTU at UCL, United Kingdom

Paul VanSteenwyk, USA

Paula Santos, UFSC, Brazil

Pedro Eduardo Alemida da Silva, REDE TB and Universidade Federal do Rio Grande, Brazil

Pete Dupree, Colorado Dept of Public Health & Environment, USA

Petros Isaakidis, MSF, India

Philipp du Cros, Medecins Sans Frontieres, United Kingdom

Pravasini Pradhan, Kalinga Network for PLHIV (KNP+), India

Prof Dave Moore, London School of Hygiene and Tropical Medicine, United Kingdom

Proud Nehanda, Medecins Sans Frontieres Southern Africa, South Africa

Rabita Aziz, Infectious Diseases Society of America, USA

Rachel Gawases, Voice of Hope Trust, Namibia

Rafaele Carla Pivetta de Araujo, HU – UFGD, Brazil

Rafaella Vezozzo, University Federal of Grande Dourados, Brazil

Raquel Tauro, Brazil

Rebecca Harris, LSHTM, United Kingdom

Regina Bhebhe, National TB Reference Laboratory Ministry of Health and Child Care, Zimbabwe

Renata Cristina Fleith, UFSC, Brazil

Richard Kelso, USA

Rinn Song, Harvard Medical School, USA

Rita de Cassia BertoloMartins, UFGD, Brazil

Robert Marshall, USA

Roberto Luiz Targa Ferreira, Grupo Hospitalar Conceicao, Brazil

Robin Montgomery, Interagency Coalition on AIDS and Development (ICAD), Canada

Roy Trevelion, United Kingdom

Ruvandhi Nathavitharana, TB Proof / Harvard Medical School, USA

Sandile Benedict Khumalo, TAC, South Africa

Sandra Palleja MD, USA

sashimeren, Mon TB Forum, India

Sbu Maseko, MSF Southern Africa, South Africa

Sebastião Martins de Souza Neto, Fundação Universidade Federal da Grande Dourados,         Brazil

Sengstake Sarah, Belgium

Shanna Livermore, USA

Sharonann Lynch, USA

Shivani Thaker, USA

Silvana Beutinger Marchioro, Federal University of Grande Dourados, Brazil

Simao Cacumba Morais Faria, Associacao SCARJoV, Angola

Stanley Mulenga, Christian Aid Ministries – CAM, Zambia

Stefanie Bolduc, DNA Genotek, Canada

Sueli Santiago Baldan, Universidade Federal de Mato Grosso do Sul and Rede TB, Brazil

Suraj Madoori, Treatment Action Group, USA

Suraya Kyei, Treatment Action Campaign, South Africa

Svetlana Doltu, NGO AFI (Act For Involvement), Republic of Moldova

Tami Segal, USA

Tendayi Westerhof, Pan African Positive Women’s Coalition-Zimbabwe, Zimbabwe

Teri Roberts, MSF Access Campaign, South Africa

Theolis Costa Barbosa Bessa, Brazil

Tom Yates, University College London, UK

Toni Williams, HST III, DSHS Texas, USA

Toutain Patricia, France

Ulick Burke, United Kingdom

Valerie Mizrahi, University of Cape Town, South Africa

Vera Suely Batista De Magalhaes, Sec.Mun.Saude De Goiania/Goias, Brazil

Will Boemer, Spahr Center/Marin AIDS Project, USA

Wilson Zulu, Zambia Association for the prevention of HIV and Tuberculosis, Zambia

Wim Vandevelde, GNP+, South Africa

Zanele Dhludhlu, MSF Southern Africa, South Africa

Zethu, South Africa

Zolani Barnes, TB/HIV Care Association, South Africa