1. The Second Stop TB Partners’ Forum Keynote address: Marcos Espinal Executive Secretary 24 March 2004 – New Delhi, India

2. 24 March 2004 Overview I. Progress: Fulfilling Amsterdam and Washington II. Preview: Plotting the way forward III. Partners: Everyone is necessary

3. 24 March 2004 “The Global Stop TB Partnership is working” Grown 50 fold: 280 members Grown 50 fold: 280 members Accelerated TB control progress and funding Accelerated TB control progress and funding Become a model for international public health partnerships Become a model for international public health partnerships Reach out to new partners—e.g. the private sector and civil society Reach out to new partners—e.g. the private sector and civil society Review progress through 2003

4. 24 March 2004 Achievements & Aims 2001–2005 “ Global Firsts” The Global Plan to Stop TB, the Global DOTS Expansion Plan, the Global Drug Facility (GDF), the Green Light Committee (GLC) and the link with the Global Fund to Fight AIDS, TB and Malaria (GFATM) By 2001: National plans and increased commitments By 2001: National plans and increased commitments By 2002: NIACCs, accelerating detection rates to 37%, and a fully operational GDF By 2002: NIACCs, accelerating detection rates to 37%, and a fully operational GDF By 2005: 70/85 TB control targets By 2005: 70/85 TB control targets

5. 24 March 2004 Working Group on DOTS Expansion Working Group on DOTS Expansion –180 countries implementing DOTS Working Group on TB/HIV Working Group on TB/HIV –Policy for TB/HIV collaborative activies Working Group on DOTS- Plus for MDR-TB Working Group on DOTS- Plus for MDR-TB –Treatment for MDR-TB in more than 10 countries The Global Plan to Stop TB Working Group on New Diagnostics Working Group on New Diagnostics –Enabling environment for commercial tool development Working Group on New TB Drugs Working Group on New TB Drugs –Pipeline of promising compounds Working Group on New Vaccines Working Group on New Vaccines –Two vaccine candidates entering phase I clinical trials

6. 24 March 2004 Progress DOTS in 180 countries > 90% pop low incidence, non-DOTS < 10% pop 10 - 90% pop No report non-DOTS DOTS coverage

7. 24 March 2004 70 80 85 100 5060708090100110120 DOTS detection rate (%) Treatment success (%) Cambodia Oman Sri Lanka Guatemala Peru Morocco Maldives Viet Nam Cuba Slovenia Solomon Is Uruguay Qata r Mongolia USA Morocco Tanzania Venezuela Djibouti Chile Nicaragua TARGET ZONE Bosnia & Hezegovina Hong Kong DR Congo El Salvador Fiji French Polynesia Italy Kazakhstan Kenya Kyrgyzstan Latvia Lebanon Malta Marshall Is Portugal St Lucia Samoa South Africa Tonga Tunisia Turks & Caicos Is It can be done— Achieved and sustained in 6 countries for four years!

8. 24 March 2004 70 80 90 100 5060708090100110120 DOTS detection rate (%) Treatment success (%) It can be done in your country TARGET ZONE 85 % 70 %

9. 24 March 2004 Global Drug Facility (GDF) Supplied TB drugs to 1.7 million DOTS patients Supplied TB drugs to 1.7 million DOTS patients Committed drugs – 2.8 million patients in 58 countries Committed drugs – 2.8 million patients in 58 countries Raised and committed US$ 30 million in grants Raised and committed US$ 30 million in grants Increased delivery-efficiency, slashed drug prices Increased delivery-efficiency, slashed drug prices Advanced combination treatments Advanced combination treatments Established direct procurement service and White List of suppliers Established direct procurement service and White List of suppliers Signed an agreement with Novartis through WHO to provide free TB drugs for 500 000 patients over the next 5 years Signed an agreement with Novartis through WHO to provide free TB drugs for 500 000 patients over the next 5 years Creating a “model,” since 2001 it has:

10. 24 March 2004 The Partnership’s “Report Card” First independent external evaluation: –Scored “extremely high” marks –Added value, new initiatives, increased funding –Made progress against TB –Supported new diagnostics, drugs and vaccines –Operationalized GDF and GLC –Increased political commitment to the Global Plan We‘ve made a great start but...

11. 24 March 2004 The clock is ticking … This is no time for complacency II. The WayForward

12. 24 March 2004 II. Preview of the future Plotting the way forward 2005 (Global Targets: 70/85) 2015 (Millennium Development Goals: halving prevalence and mortality)

13. 24 March 2004 Accelerate progress 2005 Win the “case race” ONE MILLION TB PATIENTS EXTRA EVERY YEAR

14. 24 March 2004 Accelerate progress 2005 Win the “case race” Double DOTS detection from 37% to 70% by: Double DOTS detection from 37% to 70% by: –ensuring diagnosis and cure of known TB cases according to DOTS standards –recruiting patients from non-DOTS participating clinics and hospitals and from beyond the public health systems; Inch up treatment cure rates from 82% to 85% Inch up treatment cure rates from 82% to 85% Strengthen focus on countries and communities Strengthen focus on countries and communities Focus on TB’s human face Focus on TB’s human face

15. 24 March 2004 Intensify action 2005 Bold initiatives: ISAC: Emergency ‘Intensified Support & Action Countries’ accelerates efforts in lagging HBCs ISAC: Emergency ‘Intensified Support & Action Countries’ accelerates efforts in lagging HBCs PPM DOTS: The public-private and public-public Mix DOTS casts the health care net wider PPM DOTS: The public-private and public-public Mix DOTS casts the health care net wider Global Plan Phase I: Finalize and secure funding Global Plan Phase I: Finalize and secure funding

16. 24 March 2004 Fill the resource gap in the Global Plan Funding and gaps for partnership activities, 2001–2005 Current-National Current-External Gap Total gap: US$ 3.8 billion 41% of global plan cost 0 2 4 6 8 10 DOTS Expansion Adapting DOTSR & DPartnershipTotal US$ billions

17. 24 March 2004 Why long-term goals matter TB will not go away tomorrow TB will not go away tomorrow TB is still a disease of the poor TB is still a disease of the poor Ill health and poverty are a vicious circle Ill health and poverty are a vicious circle Effective interventions exist; need to reach more people Effective interventions exist; need to reach more people Improve national TB control policies, institutions, investment Improve national TB control policies, institutions, investment Coordinate partner-donor efforts Coordinate partner-donor efforts The LIVES and CASES prevented are the bottom line

18. 24 March 2004 Long-term goals 2015 2nd Ad Hoc Committee recommendations : Consolidate, sustain, advance achievements to date Consolidate, sustain, advance achievements to date Enhance political commitment Enhance political commitment Address the health workforce crisis Address the health workforce crisis Strengthen health systems, especially PHC delivery Strengthen health systems, especially PHC delivery Accelerate responses to the TB-HIV/AIDS emergency Accelerate responses to the TB-HIV/AIDS emergency Mobilize communities and the private sector Mobilize communities and the private sector Invest in R&D to shape the future Invest in R&D to shape the future

19. 24 March 2004 Long-term goals 2015 Global Plan To Stop TB II Poverty Reduction Strategy Papers Investments plans based on well-documented needs and costing scenarios

20. 24 March 2004 Energize partnerships Partnerships play a strong role: Countries: Strengthen / building partnerships Countries: Strengthen / building partnerships HIV/AIDS community: Make TB a major issue HIV/AIDS community: Make TB a major issue Diverse partners: Define complementary roles Diverse partners: Define complementary roles Donors: Cultivate investments, expand the base Donors: Cultivate investments, expand the base Media: Raise awareness, increase advocacy & networks Media: Raise awareness, increase advocacy & networks Stakeholders: Broaden the range Stakeholders: Broaden the range

21. 24 March 2004 Develop new tools To defeat the mutable TB microbe, we must upscale efforts to develop: New diagnostics: FIND, TDR, New diagnostics: FIND, TDR, New TB drugs: Global Alliance, Novartis Institute, Glaxo Welcome New TB drugs: Global Alliance, Novartis Institute, Glaxo Welcome New vaccines: Aeras New vaccines: Aeras

22. 24 March 2004 III. Partners: To evolve dynamically and fulfil the Amsterdam Declaration and the Amsterdam Declaration and the Washington Commitment the Washington Commitment All of us here today must keep the New Delhi Pledges

23. 24 March 2004 Let us not fail “We don’t need more promises; we need to deliver on those already made.” - MDGs High-Level Forum, January 2004

24. 24 March 2004 Keep the pledges The reward will be found most meaningfully in the faces of those whose lives have been saved and health restored through our unremitting efforts.