Leading up to this year’s World Tuberculosis (TB) day on March 24th, I attended several TB related conferences, including the 47th Union World Conference on Lung Health last October, and the 21st Conference of The Union North America Region (NAR) last month. As a young researcher in the TB field, I was fascinated by the innovative new research and initiatives that were presented. Yet two specific issues facing the TB community stood out due to the frequency with which they were mentioned: (1) TB is extremely underfunded and (2) the TB community’s advocacy needs to be strengthened, especially in comparison to the HIV advocacy community.
It is well known that TB lacks major resources towards Research and Development (R&D) funding. Over the past few years, funding for TB R&D has stagnated, and last year it hit it’s lowest total in almost a decade. This is during a time when the disease continues to infect over 10 million new individuals each year, lacks an effective vaccine, has insufficient diagnostics, requires new drugs and shorter treatment regimes, and is facing the urgent threat of drug resistance.
To obtain the necessary political will to raise the capital needed, the voices of TB advocates must be loud and clear. Without dedicated funding in these areas, over 1 million people will continue to die every year due to this treatable disease, of which over 200,000 are children under 5 years old. Certain organizations, such as the Global TB caucus, Stop TB Partnership and Treatment Action Group (TAG) are taking a lead in TB advocacy, but many of us remain unsure how to become effective advocates at an individual level- as students, as professors, or as community members.
In a few weeks, I will be attending a World Health Day Parliamentary Reception in Ottawa, Canada to speak with Canada’s members of parliament (MPs) about the importance of TB, HIV and malaria research and development. This event is a fantastic opportunity to advocate for this important cause! But how does one achieve this? Through browsing TAG’s website, I came across great resources that helped me break down TB advocacy into a few easily digestible pieces. When I attend the MP reception later this spring, I will be sure to keep the following key messages and delivery strategies in mind, and urge every TB advocate to do the same.
1. Despite stagnated funding for TB R&D, the TB community has made significant progress in the past few years and this should be highlighted:
- Focusing on what politicians are not doing does not necessarily motivate these individuals to become involved in the cause. Focusing on recent successes (ex: $12.9 billion pledged in 2016 to the Global Fund to fight AIDS, TB, and malaria) and the achievements of the TB R&D community (having developed two new drugs to fight TB), will show that significant progress has been made despite the lack of available resources.
2. Highlight the broader health impact of TB R&D:
- TB R&D will also benefit people living with HIV, as the two diseases are strongly interconnected. Additionally, TB causes a large burden among women and children, but it is rarely part of discussions regarding maternal and child health. Lastly, the Sustainable Development Goals include ending the TB epidemic by 2030 to ensure healthy lives and to promote well-being for all (Goal 3).
3. Ride on the coattails of other initiatives:
- It is important to raise awareness outside of the TB community and linking up with other initiatives can help in bolstering the movement’s momentum. For example, there is a global discourse on combating antimicrobial resistance (AMR) occurring, in which drug resistant tuberculosis plays a large part. As Stephen Lewis said in his keynote speech at the Union NAR conference: “It is important for all of us to make the world understand that the relationship [between AMR and TB] is inseparable. A full third of the deaths from AMR are directly attributable to TB”. The World Health Organization did not include TB on its recently published list of antibiotic-resistant pathogens identified as priorities for threatening public health. While some may see this as a lost opportunity for TB, I see this as an impetus for greater advocacy. We need to speak up and demand that TB be included on this list; it serves as a primary resource for governmental priority setting. Stop TB Partnership, the Union, TB Alliance and TAG have already written statements, letters, and articles to get TB on the list, and have effectively disseminated these. (And I encourage you to do the same! #TBontheLIST)
4. Remember that global is local (and vice versa):
- Not only does Canada have high rates of TB at home within our aboriginal communities (Inuit populations have a TB incidence rate of around 400 times higher that non-Aboriginal Canadians and First Nations around 32 times higher), but TB is an airborne disease that is not bound by country borders. Ebola and Zika are prime examples of how diseases can be transmitted across borders and, subsequently, have significant impacts on populations far removed from the origins of the epidemic.
- In Canada, the federal government has become a global leader by contributing to the Global Fund, supporting TB REACH and showing its dedication to improving maternal and child health. In addition to these great initiatives, it will be important to continue to support innovation in R&D through Canadian scientific talent. Canada’s role in developing the Ebola vaccine is evidence that supporting our local scientific institutions creates change at the international level. By continuing to support institutions such as the Canadian Institute of Health Research and Grand Challenges Canada, Canada will be much closer to developing the technologies needed to end TB.
Delivering your message
- Often, research is not disseminated outside of the academic world. Take steps to ensure that your research reaches the public and policymakers by writing news articles and presenting your research at various events.
- When speaking with important stakeholders, ensure that your delivery is clear and concise. Do this by practicing a 3-minute elevator speech (if you were in an elevator with an important stakeholder for 3 minutes, what would you say to describe the importance of your research/cause?).
- Steer clear of acronyms – not everyone will know what creating a PPP to fight TB in LMICs will refer to.
- Learn to tweet! Not only do you connect with individuals inside and outside of your community, your message gets disseminated quickly and you must keep your messages under 140 characters - good practice for staying concise!
- Ask stakeholders how they see their role in ending TB. Engaging in two way discussions will enable us to constantly evolve our research and goals. And don’t forget to ask them how you can be a better advocate and knowledge translator.
Being an advocate takes strong key messages, evidence to back up these important messages, a strong delivery strategy and most importantly, passion towards a cause. As we approach this World TB day, I urge you to get out there to educate and engage. Everyone can be an advocate. What are you waiting for?
(Key messages and delivery strategy were informed by a talk from Christine Lubinski of Infectious Diseases Society of America (ISDA) through a TAG advocacy strategy webinar and from personal experience obtained through my work at the International TB Centre).