'Pay Now or Pay Much Later': The Cost of Inaction

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