Pay now, or Pay much more later Cost of inaction The time is now! Turning the tide on drug-resistant TB and TB/HIV co-infection in Myanmar 22-23 August 2013 “Pay now, or pay much more later” Symposium on TB, MDR-TB and TB/HIV, Yangon, 22-23 August 2013
Presentation overview • Current funding levels and gaps • Expected impact under full funding – Short term (2014-2016) – Long term: towards ending the TB epidemic
“Pay now, or pay much more later” Symposium on TB, MDR-TB and TB/HIV, Yangon, 22-23 August 2013
Funding required Largest investments needed for DOTS Largest increase needed for: rapid diagnostics/labs and MDR-TB
5
4.7
4.9
4.9
TB/HIV excl. ART
US$ billions
4 3
Rapid diagnostics, related laboratory strengthening
2.5
2
MDR-TB treatment
1
DOTS
0 Available Baseline (2011)
funds (2011)
2014
2015
2016
“Pay now, or pay much more later� Symposium on TB, MDR-TB and TB/HIV, Yangon, 22-23 August 2013
Funding and gaps, by income group 37 low-income (LICs)
Big relative gap (~60%) in LICs
1.0
US$ billions
0.5
LMICs assumed to increase domestic funding. IF NOT, much bigger gap
Gap 2014-16: $1.3 b
0.0 2014
2015
2016
Total funding gap 2014-16 US$ 4.3 billion
27 upper-middle income (UMICs) 2.5
2.5 2.0
54 lower-middle income (LMICs) 2.0
Gap 2014-16: $1.4 b
1.5
1.5
1.0
1.0
0.5
0.5
0.0 2014
0.0 2014
2015
2016
Gap 2014-16: $1.6 b
2015
“Pay now, or pay much more later” Symposium on TB, MDR-TB and TB/HIV, Yangon, 22-23 August 2013
2016
NFM – Experience with TRP engagement: Myanmar Workshop on NFM, Geneva, 9 July 2013
Impact: numbers treated Millions treated for TB
Number treated for MDR-TB 240,000
6
5.5 160,000 5
4.5 2014
2015
2016
80,000 2014
2015
17 million people treated for TB, 2014-2016 450,000 treated for MDR-TB, 2014-2016 “Pay now, or pay much more later” Symposium on TB, MDR-TB and TB/HIV, Yangon, 22-23 August 2013
2016
NFM – Experience with TRP engagement: Myanmar Workshop on NFM, Geneva, 9 July 2013
Long term impact: proposed targets 1. Universal health coverage by 2025
2. New tools available from 2025 TB incidence
Millions
-75% vs. 2015
-95% vs. 2015
<0.8 per 100,000
Rate per 100,000 population
TB deaths
10 per 100,000
â&#x20AC;&#x153;Pay now, or pay much more laterâ&#x20AC;? Symposium on TB, MDR-TB and TB/HIV, Yangon, 22-23 August 2013
How to reach targets
Existing + UHC
Millions
-75% vs. 2015
TB incidence
-95% vs. 2015 <0.8 per 100,000
R&D
Rate per 100,000 population
TB deaths
Existing + UHC
R&D 10 per 100,000
“Pay now, or pay much more later” Symposium on TB, MDR-TB and TB/HIV, Yangon, 22-23 August 2013
Take home messages • “Business as usual” won’t do • Improvements in TB control should not lead to complacency • TB control will require concerted efforts of multiple stakeholders, much beyond NTPs • Eliminating TB is a very ambitious goal, will require much time, much innovative inputs and much resources
THANK YOU ! “Pay now, or pay much more later” Symposium on TB, MDR-TB and TB/HIV, Yangon, 22-23 August 2013