Contact: Natalie Shure, natalie.shure@treatmentactiongroup.org

September 20, 2023 – As international dignitaries and political leaders gather in New York City this week for the United Nations High-Level Meeting (HLM) on TB, a sobering new analysis from Treatment Action Group (TAG) shows that governments failed to meet previous commitments to fund TB research. Although the UN General Assembly pledged to mobilize $2 billion annually for TB research and development (R&D) at the previous HLM on TB in 2018 — a promise that if honored would have amounted to $10 billion for TB R&D over the past five years — TAG finds that only $4.7 billion has been invested.

The new analysis — Far Off Track: Funding for TB Research, 2018–2022 — previews new data on TB R&D funding in fiscal year 2022 from an annual survey of biomedical research funders conducted by Treatment Action Group (TAG) with support from Stop TB Partnership. Less than half of what UN member states publicly committed to invest from 2018 to 2022 has gone toward tools the world desperately needs to find, prevent, and cure more of the 10 million new cases of TB each year. Even worse, a whopping 80% of the TB vaccine spending target remains unmet, drastically slowing scientists in developing a key component of TB elimination.

“This report highlights that world leaders have failed to keep their commitment in the 2018 UN HLM Political Declaration for mobilizing resources for research on new tools for TB,” said Dr Lucica Ditiu, Executive Director the Stop TB Partnership. “World leaders must find a way to fund the commitments with a similar sense of urgency as was done during the COVID-19 pandemic. One way to prepare for the next pandemic is to fund research on new tools for fighting an old airborne pandemic: tuberculosis.”

To bridge the gap and make good on promises that member states are set to reaffirm this week, $5 billion in R&D funding is needed each year until 2030. Concerningly, the political declaration under consideration at the UN frames this figure as an eventual goal rather than as an immediate necessity. To meet that urgent need, governments should allocate their “fair share” toward TB, defined as 0.15% of their overall R&D spending.

“We stand alongside the global TB community in calling on governments and other funders to step up and finally deliver resources whose necessity has been obvious for years now,” said Mike Frick, the TB Project Co-Director at TAG. “The UN has a duty to fuflill the human right of everyone affected by TB worldwide to share the benefits of scientific progress by accessing the best available diagnostics, treatment, and care, plus a future vaccine.”

Of course, guaranteeing TB-affected communities’ human right to science requires more than R&D funding — which is why so much of TAG’s work is geared toward making innovation accessible to those who need it. This mission inspired TAG to co-found the 1/4/6×24 Campaign last year, to demand universal access to shorter and more effective regimens to treat and prevent TB by the end of 2024. A new report from the Lancet Commission on Tuberculosis endorsed the 1/4/6×24 Campaign, stating that “new therapeutic options outlined in this report provide a compelling epidemiological, economic, and moral imperative to accelerate access to shorter, less toxic tuberculosis treatment regimens for both drug-susceptible and drug-resistant tuberculosis.”

Laying the groundwork for the realization of 1/4/6×24 requires an eye toward what late Partners in Health co-founder Paul Farmer called the “5 S’s” necessary to deliver health innovations within a larger framework of effective care: stuff, staff, space, systems, and support. Around the world, the inaccessibility of “stuff” is such a significant barrier that it has fueled broad public mobilization behind two recent campaigns led by TAG, MSF, PIH and other allies. One mobilization escalated demands that Johnson & Johnson commit to withdrawal and non-enforcement of its secondary patents on bedaquiline, the cornerstone of drug-resistant TB cures, including the regimen represented by the “6” in 1/4/6×24 — launching a high-profile pressure campaign that paved the way for broader access to generics and a lower bedaquiline price available through the Stop TB Partnership Global Drug Facility. TAG has also been a central player in ongoing efforts to push Danaher Corporation and Cepheid to reduce the price of tests for TB and resistance to key medicines, leading to this week’s announcement of a 20% price reduction for the GeneXpert test for TB and rifampicin resistance, which will now sell for $7.97 each — a critical step toward connecting more people with TB to lifesaving care and the 1/4/6 regimens.

While broad public and TB community support for these critical campaigns is encouraging, governments and funders can and should guarantee access to new TB tools before acute crises of inequitable distribution and artificial scarcities cost lives. The best way to do this is for governments to attach access conditions on the hundreds of millions of dollars they invest in R&D. Unfortunately, HLM political declarations on TB, Pandemic Prevention, Preparedness, and Response (PPPR), and Universal Health Coverage (UHC) have all failed to demand such access conditions on public funding. It’s time for powerful actors to muster the political will and resources necessary to finally end history’s oldest pandemic. TAG and TB-affected communities will accept nothing less.

# # #