Geneva, Switzerland, 24 March 2026- /African Media Agency (AMA)/- “There are various reasons for medication failure,” says Majaha Mtshali, tuberculosis (TB) focal person and staff nurse at Piggs Peak hospital in northwestern Eswatini. “When people do not take their medication correctly, whether by missing doses, taking it at the wrong times, receiving the wrong treatment, or stopping treatment early, there can be serious consequences.”
These serious consequences include drug resistance where the first-line treatment regimen no longer works. Multidrug-resistant TB (MDR-TB), a form of TB caused by bacteria resistant to at least two of the the two most powerful first-line TB medicines, is more complex and more expensive to treat. Just like drug-sensitive TB, it can also be easily transmitted through the air when a person with TB coughs, sneezes, sings or simply talks, especially in crowded or poorly ventilated settings.
This is what happened to 40-year-old Babazile Ngwenya from Manzini, Eswatini’s second largest city. When she first contracted TB in 2012, she took the first-line regimen but stopped after two months. She later developed MDR-TB, likely because of incomplete treatment, and was admitted into hospital for seven months to ensure adherence. However, this did not work. She remembers feeling “overwhelmed”.
“The drugs were too many, that’s why I was defaulting,” she says.
At this time, people with MDR-TB had to take treatment for up to 18 months, using a complex combination of daily oral and injectable medicines.
In 2022, World Health Organization (WHO) recommended a shorter six-month, all-oral regimen known as BPaL(M), making treatment simpler and easier for patients to complete. Eswatini adopted this new regimen in 2023. It is now standard treatment for patients diagnosed with MDR-TB.
“The shorter all-oral treatment regimen are preferable because they eliminate the need for painful daily injections, which can extend the treatment duration to up to 18 months, depending on the patient’s response,” says Mtshali.
When Ngwenya experienced persistent coughing, dizziness and shortness of breath in 2024 it was no surprise that she was diagnosed again with MDR-TB. “It was hard for me to admit I had TB again,” she says. She was admitted into hospital for three months because she also had anaemia and was administered the six-month BPaL(M) regimen. This time, she adhered to this easier treatment regimen and was cured.
Eswatini is one of the 30 high-burden TB countries globally. According to WHO estimates, Eswatini had a TB incidence of 319 per 100 000 population, including an estimated MDR-TB incidence of 13 per 100 000 population in 2024. “TB continues to be a major public health threat in the Kingdom of Eswatini. The situation is exacerbated by the HIV epidemic and rising rates of drug-resistant forms of TB, which are difficult to treat,” says Mduduzi Matsebula, Eswatini’s Minister of Health.
People diagnosed with MDR-TB are admitted to health facilities if they are very ill at the time of diagnosis or if their home environments do not allow adequate infection prevention and control. Discharge occurs once patients are stable and capable of continuing treatment at home.
“Adherence to treatment begins with proper counselling,” says Mtshali. “At the initiation of treatment, a patient is educated on TB disease and the importance of adherence. For MDR-TB patients, having a treatment supporter is essential.”
A range of supportive measures help the patient to adhere to treatment. Patients and their treatment supporters receive a monthly transport stipend. Monthly food packages are also given to the patient which cover 4‒6 household members. The patient’s treatment supporter, usually a family member, is provided with a card that they mark each observed dose. If the patient misses an appointment, the health facility will make a follow up by calling them. If necessary, they will also send a dedicated treatment adherence supporter on a motorbike to the patient’s home to follow up.
For Ngwenya, her support system was her family and her colleagues. “I thank my mom for being there for me, showing me love and care when I was in the hospital. If it were not for her, I would not be here,” she says.
In Eswatini, 86% of people diagnosed with MDR-TB in 2022 were treated successfully and the number of TB deaths has declined by 60% between 2015 and 2024. However, as of 2024, an estimated 54% of people with MDR-TB were either not diagnosed or initiated on appropriate treatment. Addressing these challenges requires targeted screening and a high-level of community involvement, as well as improving referral systems and data management.
WHO continues to support the Eswatini’s National TB Control Programme. In 2024, the WHO helped develop the new TB national strategic plan 2024‒2028 and the rollout of digital X-rays systems with computer aided diagnostics to strengthen TB case finding. In addition, WHO provides ongoing technical support to improve the quality of TB services and strengthen programme management.
“WHO will continue to play a central role in supporting the country to accelerate the TB response, guided by the latest WHO TB guidelines,” says Dr Susan Tembo WHO Representative in Eswatini. “Strong collaboration with affected communities and civil society remains critical to ensuring equitable access to care.”
Ngwenya is back at her job as a sales assistant at a boutique in Manzini, one that she was forced to quit after falling ill. She is well and upbeat. “TB can be treated and cured as long as you go get checked and helped when you experience symptoms,” she points out.
The 2025 Africa Malaria Progress Report reveals 270.8 million cases and nearly 600,000 deaths. It warns of potential resurgence, as Heads of State and Government urge increased domestic resource mobilisation, call on partners to honour their commitments, and demand a renewed World Bank Malaria Booster Programme.
ADDIS ABABA, Ethiopia, 16 February 2026-/African Media Agency(AMA)/- Against a backdrop of stalled progress, declining international funding, and intensifying threats, African Heads of State and Government today issued a unified call for a new era of malaria financing at the 39th African Union Summit in Ethiopia. The African Union Malaria Progress Report 2025, presented by President Advocate Duma Gideon Boko of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), warns that without urgent action, the continent risks losing decades of hard-won gains against the disease.
Urgent action required as perfect storm intensifies The 2025 report reveals that African Union Member States accounted for 270.8 million malaria cases (96% of the global total) and 594,119 deaths (97% of the global total) in 2024. Progress has stalled since 2015, and only five Member States have achieved the 2025 Catalytic Framework targets for reducing malaria incidence or mortality by 75%. These targets are part of the AU Catalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030.
The report warns that a 30% reduction in funding will result in 640 million fewer insecticide-treated nets, 146 million additional malaria cases, 397,000 additional deaths (75% among children under five), and a loss of $37 billion in GDP by 2030. Without urgent action, the report warns that malaria could resurge significantly, with cases potentially exceeding 400 million per year and deaths surpassing one million annually.
“The perfect storm of converging crises threatening malaria elimination has intensified. Official Development Assistance for health in Africa has declined by 70% in just four years, and the Eighth Replenishment of the Global Fund fell significantly short of its $18 billion target. We cannot allow these challenges to reverse decades of progress that have prevented 1.64 billion cases and saved 12.4 million lives since 2000.” ~ President Advocate Duma Gideon Boko, Republic of Botswana, Chair of ALMA
A new era of financing as Africa takes the lead In response to the funding crisis, African leaders reaffirmed their commitment to domestic resource mobilisation, innovative financing and the development of national health financing sustainability plans. The report highlights that End Malaria Councils and Funds in 12 countries have now mobilised over $200 million through public-private partnerships, demonstrating the power of multisectoral collaboration. Establishing public-private partnerships is essential for delivering sustainable financing. These partnerships can unlock new investments, propelling progress not only toward malaria elimination but also toward universal health coverage. A whole-of-society approach, engaging the private sector, philanthropic foundations, high-net-worth individuals and the diaspora through a public private health accelerator, will reinforce domestic commitments and deliver a win-win partnership.
Countries across the continent are stepping up with increased domestic financing commitments for malaria in 2025. Leaders called on global partners to honour their commitments, renew the World Bank’s Malaria Booster Programme, and align support with national strategies. The original World Bank Malaria Booster Programme (2005-2010) committed over $1 billion with transformative results. Today, African leaders are urging a renewed programme to close funding gaps, deploy next-generation tools, strengthen community health worker programmes, and build climate-resilient health systems. Investing in malaria in this way will also strengthen primary health care, making our health systems more resilient to shock and put us on a path to defeating other health challenges such as neglected tropical diseases.
“Our approach has spanned the full spectrum of what it takes to beat this disease. Tanzania has invested in world-class research and is home to the Ifakara Health Institute, where our scientists are working at the frontier of new technologies, including gene drive–an innovative approach that aims to ensure mosquitoes can no longer transmit the malaria parasite. This is African science, conducted by African researchers, addressing an African challenge.” ~ H.E. Samia Suluhu Hassan, President of the United Republic of Tanzania
New, powerful next-generation tools gaining ground Despite the challenges, the report highlights significant progress in deploying innovative tools. In 2025, 74% of insecticide-treated nets distributed across Africa were next-generation dual active-ingredient nets, up from just 20% in 2023. These nets are 45% more effective than pyrethroid-only nets against resistant mosquitoes.
Twenty-four countries have now introduced WHO-approved malaria vaccines for children under five, with 28.3 million doses distributed in 2025, up from 10.5 million in 2024. Additionally, WHO prequalified two spatial repellent products in 2025, marking the first new vector control intervention introduced in decades. A record 22 countries planned to implement seasonal malaria chemoprevention in 2025. The malaria innovation pipeline remains stronger than ever.
Promoting health sovereignty through local manufacturing Leaders emphasised the importance of local manufacturing to ensure affordability, access, and supply chain resilience. Currently, Africa imports 99% of vaccines and 95% of medicines. The report highlights that Nigeria has entered into partnerships for local production of antimalarial treatments and rapid diagnostic tests, and is working to establish the first Africa-manufactured next-generation nets.
The African Medicines Agency, with 31 countries now ratified, and Regional Economic Communities are harmonising regulatory frameworks to accelerate the registration of new commodities across the continent.
“Full deployment of existing and new tools, combined with full funding, could save over 13.2 million lives over the next 15 years and boost African economies by over $140 billion. Every dollar invested in the Global Fund delivers $19 in returns. We have the tools. We need the resources.” ~ Dr. Michael Adekunle Charles, CEO, RBM Partnership to End Malaria
What must be done The Heads of State and Government issued a clear call to action, urging all Member States to treat malaria as a central pillar of health sovereignty and economic transformation, protect and increase domestic and external funding, and fully implement the priorities of the Catalytic Framework through a Big Push Against Malaria.
Leaders called on international partners to fulfil commitments, align support with national strategies, and invest in the tools and systems that will secure a malaria-free future. They emphasised that the path ahead is challenging. Nevertheless, with determined leadership, the smart use of data, and sustained investment, Africa can bend the curve towards elimination and ensure that future generations grow up free from the threat of malaria.
Notes to Editors: The African Union Malaria Progress Report 2025 is available for download at: www.au.int and www.alma2030.org
About the Africa Malaria Progress Report: The Africa Malaria Progress Report is an annual publication prepared by the African Union Commission, African Leaders Malaria Alliance and RBM Partnership to End Malaria. It tracks progress against the AU Catalytic Framework targets, highlights challenges and threats to malaria elimination, and documents Member State actions to accelerate progress. The report is presented annually to Heads of State and Government at the African Union Summit.
About ALMA: Founded in 2009, the African Leaders Malaria Alliance (ALMA) is a ground-breaking coalition of African Heads of State and Government working across country and regional borders to achieve a malaria-free Africa by 2030. www.alma2030.org
By Zwelethu Bashman, Managing Director, MSD South Africa and Sub-Saharan Africa, Marloes Kibacha, Managing Director, Africa Health Business, Cheyenne Braganza, Senior Project Associate, Africa Health Business
JOHANNESBURG, South Africa, 22 January 2026 -/African Media Agency(AMA)/ –
Introduction Cervical cancer remains one of the leading causes of cancer-related deaths among women globally, despite being almost entirely preventable. In Africa, it continues to claim lives not because science has failed, but because policy ambition has fallen short. Over 200 strains of human papillomavirus (HPV) exist, with 12 high-risk types responsible for most HPV-related cancers. [1] Although HPV vaccines can prevent almost 90% of cervical cancer, most women remain unvaccinated, leaving cervical cancer among the top killers of women worldwide, with more than 94% of deaths occurring in low- and middle-income countries. [2] At current rates of vaccination and coverage, hundreds of thousands of African women will die from a cancer that could have been prevented with vaccines already available.
Cervical cancer hits the hardest where vulnerability is greatest. The World Health Organization (WHO) identifies sub-Saharan Africa as the region with the highest prevalence of cervical HPV, affecting nearly one in four women. [3] Women living with HIV face an even steeper risk, as weakened immune systems make them more susceptible to persistent HPV infection and four to five times more likely to develop invasive cervical cancer. [4] Without urgent action, these inequities will continue to drive preventable deaths across the continent. Recently, Gavi’s inclusion of higher-valency HPV vaccines is an important development in the global HPV prevention landscape and a relevant consideration for countries across sub-Saharan Africa as they continue to strengthen cervical cancer prevention efforts.
Vaccinating Girls First: Africa’s Critical Foundation In 2018, the WHO launched a global call to eliminate cervical cancer as a public health threat, built on three pillars: vaccination, screening, and timely treatment. Central to this strategy is fully vaccinating 90% of girls by age 15. [5] This focus on adolescent girls is a critical foundation, and African countries have made meaningful progress in recent years.
Rwanda offers a powerful example. In 2011, it became the first African country to introduce a national HPV vaccination program targeting adolescent girls through a robust school-based platform. Today, Rwanda has achieved over 90% coverage among eligible girls, one of the highest rates globally. [6] This success reflects strong political leadership, community trust, and effective delivery systems. But even Rwanda’s success highlights a fundamental limitation. High coverage among adolescent girls alone does not protect older women, boys, or men, nor does it fully interrupt HPV transmission within the broader population. A girls-only strategy, while necessary, is insufficient for elimination.
HPV Is Not a Women-Only Virus HPV continues to be framed primarily as a women’s health issue because of its link to cervical cancer. This framing is both incomplete and counterproductive. Men are not only carriers of HPV, they are also affected by HPV-related disease. Globally, one in three men is infected with at least one HPV strain, often after age 15. [7] In sub-Saharan Africa, HPV prevalence among men remains high, sustaining community-level transmission. [8]
HPV also causes anal, penile, and oropharyngeal cancers, conditions that disproportionately affect men and are increasing globally. [8, 9] Excluding boys and men from vaccination strategies perpetuates transmission to women and leaves men unprotected from largely preventable cancers.
Why Gender-Neutral Vaccination Matters for Elimination If Africa is serious about elimination, vaccination strategies must reflect how HPV actually spreads. Expanding vaccination to boys and men is not only a matter of equity, it is an epidemiological necessity. Gender-neutral vaccination accelerates herd immunity, reduces circulation of high-risk HPV types, and offers critical protection for high-risk populations, including people living with HIV. [10]
Yet progress remains uneven. Only 29 of 54 African countries have implemented national HPV vaccination programs, and nearly all focus exclusively on girls aged 9 to 14. [11]This is an important starting point, but it will not break the cycle of transmission. Elimination demands moving beyond a single cohort and a single gender.
The Forgotten Cohort: Women Who Aged Out While adolescent girls remain the priority, millions of women across Africa missed HPV vaccination entirely. Many aged out before programs were introduced, while others were missed due to COVID 19 disruptions. [12] These women, now in their 20s and 30s, represent the largest group at near term risk and will drive cervical cancer incidence over the next decade if left unprotected. [13]
In addition, women living with HIV (WLHIV) require tailored protection. Sub-Saharan Africa carries the world’s highest prevalence of HIV among women. [14] WLHIV experience higher rates of persistent HPV infection, faster quicker disease progression, increased recurrence, and poorer outcomes. Modelling shows that vaccinating WLHIV aged 10–45 could reduce new cervical cancer cases by 4.7% overall and by 10% among WLHIV. [15]
The evidence is clear. Sexually active women over 15 still benefit from HPV vaccination, as they may not have been exposed to all high-risk HPV types. [16, 17] Catch-up vaccination, particularly when combined with screening, can substantially reduce future cancer incidence. Integrating HPV vaccination into HIV care, university health services, and workplace health programs offers practical, scalable pathways to reach this cohort. [18]
The socioeconomic case is clear. Women contribute an estimated 35–45% of GDP across the region. Preventing cervical cancer protects households, sustains productivity, and reduces catastrophic health expenditure. [19] Yet across the continent, adult women remain largely invisible in HPV prevention policies. This gap is not scientific. It is political.
Leadership, Systems, and Smarter Policy Choices African governments are central to closing the HPV protection gap. While the number of countries delivering HPV vaccines has tripled since 2019 and coverage has doubled, the regional average remains just 52%, far below the 90% target. [20] Sustainable progress requires integrating HPV vaccines into routine immunization schedules, securing predictable domestic financing, and strengthening supply chains.
Kenya’s recent decision to introduce a single-dose HPV vaccine for girls shows how policy can adapt to improve efficiency and access. However, simplification alone will not address missed cohorts or limited population-level protection. Other countries in the region are also adapting policy to expand reach, with Botswana integrating higher-valency HPV vaccines within national prevention planning aligned with HIV care, and Eswatini expanding HPV vaccination in 2024 to include adolescent girls and young women living with HIV. [21, 22]
Adult vaccination pathways should be integrated into reproductive health services, alongside catch-up vaccination for older adolescents and women. Efforts should target cohorts missed by school-based programmes, including out-of-school girls and WLHIV – using multi-channel delivery platforms such as clinics, HIV programmes, mobile outreach, and innovative community-based models. [23]
As science evolves, policy must keep pace. Transitioning to nonavalent vaccines offers broader protection against high-risk HPV types and greater long-term impact in high-burden settings. [24] Procurement decisions should be driven by epidemiology, cost-effectiveness, and sustainability, not short-term constraints.
The Role of Partnerships and Innovation Industry, alongside governments and civil society, has a role to play in supporting national cervical cancer elimination goals.
Between 2021 and 2025, MSD supplied over 115 million HPV vaccine doses to low- and middle income countries, supported by a US$2 billion investment in manufacturing capacity. MSD has also reaffirmed its commitment to Gavi, the Vaccine Alliance, to support sustainable HPV vaccine supply and equitable access across Sub-Saharan Africa.
These efforts support broader vaccination strategies, including protection of older cohorts and women living with HIV, and enable country transitions to higher-valency HPV vaccines – an important step toward averting millions of future cancer cases and deaths.
The Choice Africa Must Make Africa cannot eliminate cervical cancer and all other HPV-related diseases by protecting adolescent girls alone. HPV does not respect age, gender, or delivery platforms, and elimination requires population-level protection. This means vaccinating girls, protecting boys, catching up women who were left behind, and building resilient systems that sustain coverage over time.
The tools exist. The evidence is overwhelming. What remains is the choice. If governments and partners act decisively now by expanding HPV vaccination beyond adolescent girls and investing in durable prevention systems, cervical cancer can become a disease of the past. Elimination is not a question of feasibility. It is a question of ambition, and the time to choose is now.
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[4] S. M. T. N. B. R. Liu G, “HIV-positive women have higher risk of human papilloma virus infection, precancerous lesions, and cervical cancer.,” AIDS, October 2018.
[5] K. M. K. S. Wilailak S, “Strategic approaches for global cervical cancer elimination: An update review and call for national action.,” Int J Gynaecol Obstet., 2025. [Online].
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[8] T. B. M. C. C. J. A. K. K. &. K. S. K. Olesen, “Human papillomavirus prevalence among men in sub-Saharan Africa: a systematic review and meta-analysis.,” Sexually transmitted infections, 2014.
[9] P. JM., “Human papillomavirus-related disease in men: not just a women’s issue.,” J Adolesc Health, 2010.
[10] G. J. Scheepers VC, “Expanding the case for gender-neutral human papillomavirus vaccination in South Africa: Emerging neonatal and ethical considerations.,” Afr J Prim Health Care Fam Med., 2025.
[11] E. I. Eric Asempah, “Accelerating HPV vaccination in Africa for health equity,” PubMed Central- National Library of Medicine, no. PMID: 39294815, 2024.
[12] I. L. C. M. Sad SA, “Revisiting HPV vaccination post-COVID: geopolitical, sociocultural, and ethical disparities in global health,” Int J Equity Health., 2025.
[13] S. P. Castanon A, “Is the recent increase in cervical cancer in women aged 20-24years in England a cause for concern?,” Prev Med., 2018.
[15] W. J. e. al., “Modelling the Impact of HPV Vaccination among Women Living with HIV.,” Lancet Global Health.
[16] X. M. N. P. P. F. D. M. J. A. K. L. J. M. E. M. S. B. O. M. B. J. V. S. H. R. M. &. S. A. Castellsagué, “End-of-study safety, immunogenicity, and efficacy of quadrivalent HPV (types 6, 11, 16, 18) recombinant vaccine in adult women 24- 45 years of age.,” British journal of cancer, 2011.
[17] “Human papillomavirus vaccination for adult women,” Rev Bras Ginecol Obstet, 2022.
[18] S. N. e. B. E. A.-D. Kimeshnee Govindsamy, “Effectiveness of integrating cervical cancer prevention strategies into HIV care programmes: A mixed-methods systematic review protocol,” PLOS One, 2024.
[23] “Cervical Cancer Data Surveillance in Sub-Saharan Africa,” WHO & IARC, 2022. [Online]. Available: https://gco.iarc.fr/.
[24] V. V. C. H. e. a. Bobadilla ML, “Human Papillomavirus (HPV) Infection and Risk Behavior in Vaccinated and Non Vaccinated Paraguayan Young Women.,” Pathogens, 2024.
[25] T. G. e. al., “Implementing HPV Vaccination Services in People Living with HIV in Trinidad and Tobago: A Brief Report,” Cancer Epidemiol Biomarkers, 2025.
[26] G. M. E. Al., “Human papilloma virus vaccination in the resource-limited settings of sub-Saharan Africa: Challenges and recommendations,” Vaccine X, vol. 20, 2024.
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[31] e. a. Alison G Abraham, “Invasive cervical cancer risk among HIV-infected women: A North American multi-cohort collaboration prospective study,” PubMed Central- National Library of Medicine, no. doi: 10.1097/QAI.0b013e31828177d7, 2014.
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New Goalkeepers Report models impact of global health funding cuts, offers roadmap of best buys and most effective investments to slow this reversal
SEATTLE, 4 December 2025 -/African Media Agency (AMA)/- The number of children dying before their 5th birthday is projected to rise for the first time this century, reversing decades of global progress, according to new data published today in the Gates Foundation’s 2025 Goalkeepers Report.
In 2024, 4.6 million children died before their 5th birthday. According to modeling in the report, conducted by the Institute for Health Metrics and Evaluation (IHME), that number is projected to rise by just over 200,000—to an estimated 4.8 million children this year. At the same time, global development assistance for health fell sharply this year—26.9% below 2024 levels.
Beyond this year’s drastic funding cuts, countries face mounting debt, fragile health systems, and the risk of losing hard-won gains against diseases like malaria, HIV, and polio.
The report, We Can’t Stop at Almost, warns that if global health funding cuts persist, up to 16 million more children could die by 2045. It offers a roadmap for how targeted investments in proven solutions and next generation innovations can save millions of children’s lives, preventing a reversal in progress in today’s constrained budget environment.
“I wish we were in a position to do more with more because it’s what the world’s children deserve. But even in a time of tight budgets, we can make a big difference,” writes Bill Gates, chair of the Gates Foundation and the report’s author. “I’ll continue to advocate however and wherever I can for increased funding for the health of the world’s children—and for efficiencies that improve our current system. But with millions of lives on the line, we have to do more with less, now.”
A Critical Turning Point
Projections by the IHME show that if global health funding cuts of 20% persist, an additional 12 million children could die by 2045. A 30% permanent cut would bring that toll to 16 million.
Gates describes this moment as a turning point for global health, when the right choices can still save millions of lives.
“We could be the generation who had access to the most advanced science and innovation in human history—but couldn’t get the funding together to ensure it saved lives,” Gates writes. “By making the right priorities and commitments, and investing in high-impact solutions, I’m confident we can stop a significant reversal in child deaths and help ensure millions more children are alive in 2045.”
In the report, Gates identifies investments with the greatest potential to save millions of young lives. He calls for doubling down on the most effective interventions—primary health care, routine immunizations, better vaccines, and new uses of data—to stretch every dollar. For
example:
For less than $100 per person per year, strong primary health care systems can prevent up to 90% of child deaths.
Every $1 spent on vaccines returns $54 in economic and social benefits. Through Gavi, the Vaccine Alliance, more than 1.2 billion children have received lifesaving vaccines since 2000.
The work of the Global Fund to Fight AIDS, Tuberculosis and Malaria is also evidence of what sustained investment can achieve. As one of the most effective engines in health, the Global Fund has saved 70 million lives and reduced deaths from malaria, TB, and HIV by more than 60% since 2002. Late last month, leaders pledged $11.34 billion to the Global Fund’s Eighth Replenishment, underscoring continued global commitment to fighting these diseases while laying bare the risks of stepping back.
According to Gates, investment in the development of next-generation innovations could end some of the deadliest threats to children, such as malaria and pneumonia, for good. Modeling in the report projects that sustained funding in these innovations could save millions of children by 2045.
Next-generation vaccines for respiratory syncytial virus and pneumonia could save 3.4 million children.
New malaria tools could save another 5.7 million children, while long-acting HIV prevention tools like lenacapavir could help drive infections and deaths toward zero in high-burden countries.
Local Leadership, Global Action
The report also features essays with firsthand perspectives from leaders, health workers, and researchers in Africa and Asia who are advancing solutions to sustain progress:
In Nigeria, Muhammad Inuwa Yahaya, governor of Gombe State, prioritized primary health and education amid a budget deficit. “You don’t need perfect conditions to make progress. You need clarity, and the courage to stick to it.”
In Kenya, community health worker Josephine Barasa continued volunteering in her community after losing her paid position, providing care and education to mothers and children. “They could take away the money, but they couldn’t take me away from my women… The support systems may have disappeared, but the need has not. And neither have I.”
In Uganda, entomologist Krystal Mwesiga Birungi is developing next-generation tools to combat malaria. “Ending malaria is not only possible, it is urgent,” she said. “We African researchers know this—and we are leading the way.”
In India, Dr. Naveen Thacker, a pediatrician, underscored the importance of affordable and accessible vaccines. “If we want to see more healthy children, affordability of vaccines is key.”
Gates implores governments, philanthropies, and citizens to act on the report’s findings by safeguarding or expanding funding, increasing philanthropic giving, and reminding leaders that every child deserves the chance to survive and thrive, no matter where they are born.
“We can’t stop at almost,” Gates writes. “If we do more with less now—and get back to a world where there are more resources to devote to children’s health—then in 20 years we’ll be able to tell a different kind of story: how we helped more kids survive childbirth—and childhood.”
Guided by the belief that every life has equal value, the Gates Foundation works to help all people lead healthy, productive lives. In developing countries, we work with partners to create impactful solutions so that people can take charge of their futures and achieve their full potential. In the United States, we aim to ensure that everyone—especially those with the fewest resources—has access to the opportunities needed to succeed in school and life. Based in Seattle, Washington, the foundation is led by CEO Mark Suzman, under the direction of Bill Gates and our governing board.
About Goalkeepers
Goalkeepers is the foundation’s campaign to accelerate progress towards the Sustainable Development Goals (Global Goals). By sharing stories and data behind the Global Goals through an annual report, the Gates Foundation hopes to inspire a new generation of leaders—Goalkeepers who raise awareness of progress, hold their leaders accountable, and drive action to achieve the Global Goals.
About the Global Goals
On September 25, 2015, at the United Nations headquarters in New York, 193 world leaders committed to the 17 Sustainable Development Goals (Global Goals). These are a series of ambitious objectives and targets to achieve three extraordinary things by 2030: end poverty, fight inequality and injustice, and fix climate change.
KAMPALA, Uganda, 15 October 2025 -/African Media Agency(AMA)/-Malaria is a preventable disease that still claims over half a million African lives every year, and mostly children under the age of five. Ugandan researcher, Krystal Birungi, a malaria survivor herself has dedicated her life, and profession, to changing this reality.
Krystal Mwesiga Birungi, Ugandan scientist, malaria advocate, and Research & Outreach Associate at Target Malaria Uganda at the Uganda Virus Research Institute (UVRI), has achieved a string of outstanding achievements that reflect her lifelong commitment to eliminating malaria and protecting children’s lives across Africa and beyond.
Her journey is deeply personal. Her childhood was marked by repeated bouts of malaria, and the fear that her younger brother might not survive. “Those early years embedded the conviction in me that malaria is not just a scientific challenge, but a moral and social injustice,” says Birungi.
Today, Krystal brings that dual force of lived experience and scientific rigor to initiatives shaping the future of public health, equality, and child survival.
A voice on the global stage
In 2025, Krystal contributed a powerful essay to Hope for Life on Our Planet: Inspiration for Seven Generations, a global collection of reflections edited by Osvald Bjelland. Her essay, “Breaking the chains: Addressing public health inequities in the fight against malaria,” was launched in London alongside contributions from voices, such as Dame Jane Goodall and Pope Francis.
She used her essay to spotlight the disproportionate burden of malaria on African women and children, and to argue for equity and investment in cutting-edge innovations and policy reform.
Elevating leadership – locally and internationally
In September 2025, Krystal Birungi was selected as part of the 2025–2026 Obama Foundation Leaders Africa class. Among over 200 global changemakers, she is one of just 35 Africans chosen to receive training in leadership, civic engagement, and cross-sector collaboration.
Krystal regularly participates in global advocacy missions (including with The Global Fund Advocates Network), educating policymakers, donors, and the public about malaria research, prevention, and equity.
The Global Fund, a key partner in malaria control, reported in 2025 that its overall work (against HIV, TB, and malaria) has helped save 70 million lives since its inception, with a 63% decline in combined death rates.
Krystal’s fight for Africa’s survival
Krystal’s own survival gives urgency to her work for Africans. “In 2023, 94% of the world’s malaria cases, and 95% of malaria deaths happened in Africa. I am driven everyday by the data and by the faces behind it, because every statistic is someone’s child, friend, or family,” adds Birungi.
On many global stages, Krystal has shared a vivid account of childhood suffering. Her brother convulsing from malaria, her family repeatedly sick and not being able to afford life-saving medicine. That personal history fuels both her empathy and her resolve.
She has helped explain complex tools like dual-insecticide nets, spatial repellents, new drug formulations, vaccines and genetically modified mosquitoes – emphasising that no single tool is enough, and that community involvement, national leadership, and equity concerns matter every step of the way.
As an entomologist, Krystal reiterates the critical role of ongoing research, from understanding mosquito behavior to developing next-generation tools to support and strengthen public health equity.
By 2035, she believes the world can push malaria from a common threat to a manageable, largely prevented disease, using vaccines, better tools, strong health systems, and equity-driven research.
By 2040, the dream is elimination in many high-burden areas, with technologies like gene drive helping stop transmission entirely.
Krystal says her vision is not just scientific optimism, but a call to collective responsibility: global donors, African governments, research institutions, and communities must invest, innovate, and lead together.
Target Malaria is an international not-for-profit research consortium that aims to develop and share new, cost-effective and sustainable genetic technologies to modify mosquitoes and reduce malaria transmission. Our vision is to contribute to a world free of malaria. We aim to achieve excellence in all areas of our work, creating a path for responsible research and development of genetic technologies, such as gene drive. www.targetmalaria.org
Target Malaria receives core funding by the Gates Foundation and Open Philanthropy. The lead grantee organization is Imperial College London with partners in Africa, Europe and North America.
At 2025 Goalkeepers event, Gates lays out roadmap for saving millions more children’s lives by 2045 if governments stretch every dollar and scale a pipeline of affordable, lifesaving innovations
Announces new pledge to the Global Fund 2026-2028 replenishment to prevent deaths from AIDS, TB, and malaria
Honors President of the Government of Spain with 2025 Global Goalkeeper Award and 10 champions for their ingenuity and resilience, and for offering hope, solutions in the face of steep funding cuts
NEW YORK, United States of America, September 23rd, 2025 -/African Media Agency (AMA)/- At its 2025 Goalkeepers event, Gates Foundation Chair Bill Gates stood before an audience of more than 1,000 global government, community, philanthropy, and private-sector leaders and issued a stark but hopeful call to world leaders: save millions of children’s lives and make some of the deadliest diseases history by 2045.
“Humanity is at a crossroads. With millions of children’s lives on the line, global leaders have a once-in-a-generation chance to do something extraordinary,” said Gates. “The choices they make now—whether to go forward with proposed steep cuts to health aid or to give the world’s children the chance they deserve to live a healthy life—will determine what kind of future we leave the next generation.”
This year, donor countries dealing with domestic challenges, high debt levels, and aging populations made dramatic funding cuts to global development assistance for health (DAH). According to a recent study by the Institute for Health Metrics and Evaluation (IHME), global DAH fell by 21% between 2024 and 2025, and is now at a 15-year low. With key global health funding decisions expected before the end of the year, total funding levels could rise. However, if the current cuts hold, they threaten decades of progress that saw child mortality cut in half since 2000—from 10 million children to less than 5 million children a year—one of humanity’s greatest achievements.
During the annual event, which this year focused on reigniting a shared commitment to saving children’s lives, Gates announced his foundation’s pledge of $912 million over three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria’s 2026-2028 replenishment. The Global Fund is one of the most effective lifesaving initiatives of the 21st century. Its fundraising replenishment cycle ends this November, underscoring the urgency for governments to make pivotal decisions in the coming weeks and months for the lives of millions of people.
“What’s happening to the health of the world’s children is worse than most people realize, but our long-term prospects are better than most people can imagine,” said Gates. “I don’t expect most governments to suddenly restore foreign aid to historic levels, but I am an optimist, and I believe governments can and will do what’s needed to save as many children as possible,” said Gates.
With shrinking global health budgets as the backdrop, the Goalkeepers event highlighted the people, science and innovations, and policies that are accelerating solutions for how leaders can do more with less.
A Roadmap to a Healthier Future
“We have a roadmap for saving millions of children and making some of the deadliest childhood diseases history by 2045,” Gates asserted. “I’m urging world leaders to invest in the health of all people, especially children, to deliver this future.”
Results from work by the Gates Foundation and the IHME indicate that sustaining global investments in child health and scaling lifesaving innovations could cut child deaths in half again over the next 20 years.
The roadmap includes:
Renewing investments in proven initiatives, such as the Global Fund and Gavi, the Vaccine Alliance, to help countries make smarter, more cost-effective health decisions; gain access to proven vaccines, medicines, and treatments; and focus on sustainability and transitioning to self-reliance
Prioritizing primary health care systems—even in the face of challenging budget decisions—to prevent, detect, and treat childhood illnesses early
Investing in further R&D and effectively rolling out breakthrough innovations that include:
A suite of new approaches to combating malaria, including innovations that prevent mosquitoes from carrying parasites and single-dose treatments to accelerate eradication of the disease
Long-acting HIV drugs and prevention options that replace daily pills to drive AIDS deaths down to single digits
New maternal vaccines against respiratory syncytial virus (RSV) and group B streptococcus (GBS) that have the potential to protect babies from deadly respiratory illnesses
Artificial intelligence to leverage smarter, faster, and cheaper delivery of safe, cost-effective medicines to dramatically improve lives
A New Three-Year Commitment to the Global Fund
Since 2002, the Global Fund has saved more than 70 million lives; reduced deaths from AIDS, TB, and malaria by more than 60%; and strengthened global health security. Each dollar invested in the Global Fund delivers an estimated $19 in health and economic returns.
The foundation’s new pledge brings its total commitments to the Global Fund to $4.9 billion since 2002, making it one of the foundation’s largest investments. The pledge aims to galvanize governments, philanthropists, and the private sector to come to the table with significant investments for the fund’s Eighth Replenishment, which is co-hosted by South Africa and the United Kingdom. With millions of lives on the line, the level of investment in the Global Fund over the next three years will determine whether the world saves millions of lives; curbs HIV, TB, and malaria; and bolsters economies and global health security.
“An entire generation is alive today thanks to the world’s generosity, smart investments, and the hard work of governments and Global Fund partners,” Gates said. “Now, we must go further so the next generation grows up in a world where no child dies from preventable causes.”
Celebrating Goalkeeper Award and Champions
In recognition of his continued commitment to advance the Global Goals, the foundation announced President of the Government of Spain Pedro Sánchez as the winner of its 2025 Global Goalkeeper Award. Under Prime Minister Sanchez’s leadership, Spain increased contributions to the Global Fund this year by nearly 12% and to Gavi by 30%, expanded official development assistance (ODA), and hosted the landmark International Conference on Financing for Development in June 2025.
The event also honored Goalkeepers Champions—experts, innovators, and advocates driving progress in child survival worldwide. They include:
Dr. Abhay Bang and Dr. Rani Bang (India) – Pioneering community-based health care in India
David Beckham (UK) – Advocating for child health and education
Krystal Mwesiga Birungi (Uganda) – Championing youth-centered policies and equitable health access across Africa
Toni Garrn (Germany) – Mobilizing resources to expand education and health care for girls
John Green (USA) – Using storytelling and advocacy to spark vital conversations on tuberculosis and mental health among young people
Osas Ighodaro (Nigeria) – Driving awareness and action in the fight against malaria
Dr. Donald Kaberuka (Rwanda) – Advancing global health financing for effective health system strengthening and expanding access to health care worldwide
Jerop Limo (Kenya) – Advancing HIV awareness and care for children and families across Africa
Reem Al-Hashimy (United Arab Emirates) – Championing investments in health and education through initiatives like Dubai Cares
Dr. Naveen Thacker (India) – Advancing child health through community-based innovations
“We Can’t Stop at Almost”
The Goalkeepers event was co-hosted by singer, songwriter, and composer Jon Batiste, who returned as musical curator for the second year with the PS22 elementary school choir, and actress and director Olivia Wilde. Together, they urged the audience to remember that while the world has made progress, “we can’t stop at almost,” which was the event’s theme.
Community champions, scientists, health workers, faith leaders, and activists from Bangladesh, Indonesia, Kenya, Madagascar, Nigeria, Senegal, South Africa, Uganda, and the United States shared powerful stories of resilience and innovation. Several showcased breakthrough technologies already saving lives and moving the world closer to eradicating deadly diseases.
“Every year, Goalkeepers unites changemakers to inspire and push one another forward,” said Dawda Jobarteh, deputy director of the foundation’s Goalkeepers campaign. “Together, we can reimagine a future without preventable child deaths and unlock the next wave of breakthroughs for the world’s children.”
Event session presenters included Rick Warren, pastor and author; El Hadji Mansour Sy, co- president of World Council of Religions for Peace; Ingrid Silva, ballet dancer and activist; Krista Tippett, journalist and author; Latif Nasser, co-host of “Radiolab”; and Budi Gunadi Sadikin, Indonesia’s minister of health.
Looking Ahead
Later this year, Goalkeepers will expand to the Middle East for the first time, convening leaders, innovators, and changemakers from across the region and beyond in Abu Dhabi on December 8.
Ahead of that, the foundation will release its 2025 Goalkeepers Report, focusing on the impact that leaders’ choices between now and the end of the year will have on saving children’s lives.
Earlier this year, Gates made a historic announcement that he would give away virtually all of his wealth to the foundation to advance progress on saving and improving lives. He also announced the foundation would spend $200 billion over the next 20 years, working with its partners to make as much progress as possible towards three primary goals: end preventable deaths of moms and babies; ensure the next generation grows up without having to suffer from deadly infectious diseases; and lift millions of people out of poverty, putting them on a path to prosperity. At the end of the 20-year period, the foundation will sunset its operations.
Photos and b-roll from the event, full bios of the Goalkeepers champions, and more can be found here.
Guided by the belief that every life has equal value, the Gates Foundation works to help all people lead healthy, productive lives. In developing countries, we work with partners to create impactful solutions so that people can take charge of their futures and achieve their full potential. In the United States, we aim to ensure that everyone—especially those with the fewest resources—has access to the opportunities needed to succeed in school and life. Based in Seattle, Washington, the foundation is led by CEO Mark Suzman, under the direction of Bill Gates and our governing board.
About Goalkeepers
Goalkeepers is the foundation’s campaign to accelerate progress toward the Sustainable Development Goals (Global Goals). By sharing stories and data behind the Global Goals through an annual report, the Gates Foundation hopes to inspire a new generation of leaders— Goalkeepers who raise awareness of progress, hold their leaders accountable, and drive action to achieve the Global Goals.
At 2025 Goalkeepers event, Gates lays out roadmap for saving millions more children’s lives by 2045 if governments stretch every dollar and scale a pipeline of affordable, lifesaving innovations
Announces new pledge to the Global Fund 2026-2028 replenishment to prevent deaths from AIDS, TB, and malaria
Honors President of the Government of Spain with 2025 Global Goalkeeper Award and 10 champions for their ingenuity and resilience, and for offering hope, solutions in the face of steep funding cuts
NEW YORK, United States of America, September 23rd, 2025 -/African Media Agency (AMA)/- At its 2025 Goalkeepers event, Gates Foundation Chair Bill Gates stood before an audience of more than 1,000 global government, community, philanthropy, and private-sector leaders and issued a stark but hopeful call to world leaders: save millions of children’s lives and make some of the deadliest diseases history by 2045.
“Humanity is at a crossroads. With millions of children’s lives on the line, global leaders have a once-in-a-generation chance to do something extraordinary,” said Gates. “The choices they make now—whether to go forward with proposed steep cuts to health aid or to give the world’s children the chance they deserve to live a healthy life—will determine what kind of future we leave the next generation.”
This year, donor countries dealing with domestic challenges, high debt levels, and aging populations made dramatic funding cuts to global development assistance for health (DAH). According to a recent study by the Institute for Health Metrics and Evaluation (IHME), global DAH fell by 21% between 2024 and 2025, and is now at a 15-year low. With key global health funding decisions expected before the end of the year, total funding levels could rise. However, if the current cuts hold, they threaten decades of progress that saw child mortality cut in half since 2000—from 10 million children to less than 5 million children a year—one of humanity’s greatest achievements.
During the annual event, which this year focused on reigniting a shared commitment to saving children’s lives, Gates announced his foundation’s pledge of $912 million over three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria’s 2026-2028 replenishment. The Global Fund is one of the most effective lifesaving initiatives of the 21st century. Its fundraising replenishment cycle ends this November, underscoring the urgency for governments to make pivotal decisions in the coming weeks and months for the lives of millions of people.
“What’s happening to the health of the world’s children is worse than most people realize, but our long-term prospects are better than most people can imagine,” said Gates. “I don’t expect most governments to suddenly restore foreign aid to historic levels, but I am an optimist, and I believe governments can and will do what’s needed to save as many children as possible,” said Gates.
With shrinking global health budgets as the backdrop, the Goalkeepers event highlighted the people, science and innovations, and policies that are accelerating solutions for how leaders can do more with less.
A Roadmap to a Healthier Future
“We have a roadmap for saving millions of children and making some of the deadliest childhood diseases history by 2045,” Gates asserted. “I’m urging world leaders to invest in the health of all people, especially children, to deliver this future.”
Results from work by the Gates Foundation and the IHME indicate that sustaining global investments in child health and scaling lifesaving innovations could cut child deaths in half again over the next 20 years.
The roadmap includes:
Renewing investments in proven initiatives, such as the Global Fund and Gavi, the Vaccine Alliance, to help countries make smarter, more cost-effective health decisions; gain access to proven vaccines, medicines, and treatments; and focus on sustainability and transitioning to self-reliance
Prioritizing primary health care systems—even in the face of challenging budget decisions—to prevent, detect, and treat childhood illnesses early
Investing in further R&D and effectively rolling out breakthrough innovations that include:
A suite of new approaches to combating malaria, including innovations that prevent mosquitoes from carrying parasites and single-dose treatments to accelerate eradication of the disease
Long-acting HIV drugs and prevention options that replace daily pills to drive AIDS deaths down to single digits
New maternal vaccines against respiratory syncytial virus (RSV) and group B streptococcus (GBS) that have the potential to protect babies from deadly respiratory illnesses
Artificial intelligence to leverage smarter, faster, and cheaper delivery of safe, cost-effective medicines to dramatically improve lives
A New Three-Year Commitment to the Global Fund
Since 2002, the Global Fund has saved more than 70 million lives; reduced deaths from AIDS, TB, and malaria by more than 60%; and strengthened global health security. Each dollar invested in the Global Fund delivers an estimated $19 in health and economic returns.
The foundation’s new pledge brings its total commitments to the Global Fund to $4.9 billion since 2002, making it one of the foundation’s largest investments. The pledge aims to galvanize governments, philanthropists, and the private sector to come to the table with significant investments for the fund’s Eighth Replenishment, which is co-hosted by South Africa and the United Kingdom. With millions of lives on the line, the level of investment in the Global Fund over the next three years will determine whether the world saves millions of lives; curbs HIV, TB, and malaria; and bolsters economies and global health security.
“An entire generation is alive today thanks to the world’s generosity, smart investments, and the hard work of governments and Global Fund partners,” Gates said. “Now, we must go further so the next generation grows up in a world where no child dies from preventable causes.”
Celebrating Goalkeeper Award and Champions
In recognition of his continued commitment to advance the Global Goals, the foundation announced President of the Government of Spain Pedro Sánchez as the winner of its 2025 Global Goalkeeper Award. Under Prime Minister Sanchez’s leadership, Spain increased contributions to the Global Fund this year by nearly 12% and to Gavi by 30%, expanded official development assistance (ODA), and hosted the landmark International Conference on Financing for Development in June 2025.
The event also honored Goalkeepers Champions—experts, innovators, and advocates driving progress in child survival worldwide. They include:
Dr. Abhay Bang and Dr. Rani Bang (India) – Pioneering community-based health care in India
David Beckham (UK) – Advocating for child health and education
Krystal Mwesiga Birungi (Uganda) – Championing youth-centered policies and equitable health access across Africa
Toni Garrn (Germany) – Mobilizing resources to expand education and health care for girls
John Green (USA) – Using storytelling and advocacy to spark vital conversations on tuberculosis and mental health among young people
Osas Ighodaro (Nigeria) – Driving awareness and action in the fight against malaria
Dr. Donald Kaberuka (Rwanda) – Advancing global health financing for effective health system strengthening and expanding access to health care worldwide
Jerop Limo (Kenya) – Advancing HIV awareness and care for children and families across Africa
Reem Al-Hashimy (United Arab Emirates) – Championing investments in health and education through initiatives like Dubai Cares
Dr. Naveen Thacker (India) – Advancing child health through community-based innovations
“We Can’t Stop at Almost”
The Goalkeepers event was co-hosted by singer, songwriter, and composer Jon Batiste, who returned as musical curator for the second year with the PS22 elementary school choir, and actress and director Olivia Wilde. Together, they urged the audience to remember that while the world has made progress, “we can’t stop at almost,” which was the event’s theme.
Community champions, scientists, health workers, faith leaders, and activists from Bangladesh, Indonesia, Kenya, Madagascar, Nigeria, Senegal, South Africa, Uganda, and the United States shared powerful stories of resilience and innovation. Several showcased breakthrough technologies already saving lives and moving the world closer to eradicating deadly diseases.
“Every year, Goalkeepers unites changemakers to inspire and push one another forward,” said Dawda Jobarteh, deputy director of the foundation’s Goalkeepers campaign. “Together, we can reimagine a future without preventable child deaths and unlock the next wave of breakthroughs for the world’s children.”
Event session presenters included Rick Warren, pastor and author; El Hadji Mansour Sy, co- president of World Council of Religions for Peace; Ingrid Silva, ballet dancer and activist; Krista Tippett, journalist and author; Latif Nasser, co-host of “Radiolab”; and Budi Gunadi Sadikin, Indonesia’s minister of health.
Looking Ahead
Later this year, Goalkeepers will expand to the Middle East for the first time, convening leaders, innovators, and changemakers from across the region and beyond in Abu Dhabi on December 8.
Ahead of that, the foundation will release its 2025 Goalkeepers Report, focusing on the impact that leaders’ choices between now and the end of the year will have on saving children’s lives.
Earlier this year, Gates made a historic announcement that he would give away virtually all of his wealth to the foundation to advance progress on saving and improving lives. He also announced the foundation would spend $200 billion over the next 20 years, working with its partners to make as much progress as possible towards three primary goals: end preventable deaths of moms and babies; ensure the next generation grows up without having to suffer from deadly infectious diseases; and lift millions of people out of poverty, putting them on a path to prosperity. At the end of the 20-year period, the foundation will sunset its operations.
Photos and b-roll from the event, full bios of the Goalkeepers champions, and more can be found here.
Guided by the belief that every life has equal value, the Gates Foundation works to help all people lead healthy, productive lives. In developing countries, we work with partners to create impactful solutions so that people can take charge of their futures and achieve their full potential. In the United States, we aim to ensure that everyone—especially those with the fewest resources—has access to the opportunities needed to succeed in school and life. Based in Seattle, Washington, the foundation is led by CEO Mark Suzman, under the direction of Bill Gates and our governing board.
About Goalkeepers
Goalkeepers is the foundation’s campaign to accelerate progress toward the Sustainable Development Goals (Global Goals). By sharing stories and data behind the Global Goals through an annual report, the Gates Foundation hopes to inspire a new generation of leaders— Goalkeepers who raise awareness of progress, hold their leaders accountable, and drive action to achieve the Global Goals.
Filmmaker Mads Brugger uncovers plot to infect black Africans with HIV
Geneva-based financing group, Global Fund, has granted K385 billion to Government of Malawi to help in the fight against HIV and AIDS, Tuberculosis and Malaria.
A statement from Global Fund to Ministry of Finance and Economic Planning and Development dated December 16, 2019 says Malawi’s allocation of funds is available for 2020-2022 period and will be utilized between January 1, 2021 to June 30, 2024.
The statement further forecasts hope that Malawi’s progress in the fight against TB, Malaria and HIV promises to bear fruits before the internationally-agreed cutoff line of 2030.
Mosquito: it causes malaria
“Together we can recognize and applaud the massive progress made, and we can share collective determination to accelerate efforts to end these epidemics and ensure better health and wellbeing for all by 2030,” reads part of the statement which has been signed by Mark Eldon-Edington, head of Grant Management Division.
Under the grant, HIV has been given a lion’s share of K295 billion (U$393,004,813), TB K15 billion (US$19,950,195) while Malaria has received an allocation of K75 billion (US$99,984,069).
Governance and economic observers say the allocation of funds is significant as it rides on good financial and democratic governance under the leadership of Professor Arthur Mutharika and his governing Democratic Progressive Party (DPP).
They point out that this huge grant signifies restoration of trust by international development partners.
Founded in 2002 in Geneva, Global Fund is an international financing and partnership organization that mobilizes resources to fight HIV/AIDS, TB and Malaria and strengthen health systems around the world.
Governments of over 190 nations meet at the 70th World Health Assembly (WHO), to decide on the agenda of WHO for next year, and elect the new head of WHO. This article is based on interviews with several parliamentarians, global health experts, and patients.
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When major weak-spots go beyond the purview of health ministries, inter-sectoral programming becomes critical to progress towards ending tuberculosis (TB) by 2030, globally. The Indian Government committed to end TB by 2025 – a welcome political commitment indeed – but it warrants urgent and unprecedented actions to muscle up the required pace to keep this promise.
As our governments meet at the ongoing 70th World Health Assembly (#WHA70) to decide the agenda for the World Health Organization (WHO) and to elect its new Director General, we do hope they also prioritise inter-sectoral programming beyond ministries of health so that TB declines at the required rate to end TB as envisaged. Current TB decline rates are a fraction of the required rate for TB decline in order to end TB by 2030.
INTERDEPENDENCE — KEY TO END TB
The wise words of Mahatma Gandhi, “Interdependence is and ought to be as much the ideal of human as self-sufficiency” provide a good compass when we think of ending TB. Scientific evidence shows that major risk factors for transmission of TB infection as well as those that jeopardize treatment are often beyond the purview of health ministries. If we are to end TB, we ought to ensure that there is no further spread of TB, as well as, every person with TB gets prompt access to accurate diagnosis and gets cured by effective treatment and support.
We slip backwards in fight against TB with each new infection transmission, and, every time we fail to accurately and timely diagnose, treat and cure TB. The journey to the #endTB finish line, consists of small but significant victories when we prevent TB transmission, accurately and timely diagnose each case of TB, treat the person promptly with effective treatment regimen and ensure treatment completion and cure.
POLITICAL WILL IS FIRMING UP
Governments of 194 countries globally have demonstrated their commitment to integrated development by adopting the UN Sustainable Development Goals (SDGs) in 2015. This is ‘no brainer’ that to succeed on any one of the seventeen SDGs, we also have to succeed on the remaining ones too. Healthy independence also warrants healthy interdependence to achieve shared visions and progress collectively towards common goals.
Even before SDGs got adopted, at the World Health Assembly 2014, the Ministers of Health of over 190 governments had approved the WHO End TB Strategy.
In addition to these global commitments to end TB, domestic political will is also firming up. India bears the highest burden of TB globally. Indian government’s National Health Policy 2017 promises to eliminate TB by 2025.
At 2017 World Health Day, the Himachal Pradesh state government announced to end TB by 2021-2022 at TB Free India Summit held in Dharamshala, Himachal Pradesh, India. TB Free India Summit organized by the Ministry of Health and Family Welfare of Government of India, International Union Against TB and Lung Disease (The Union) and partners, had brought together not just those involved in fighting TB but also other ministers, parliamentarians, Bollywood film-stars, cricketers, corporate private sector representatives, public sector representatives, scientists, media, TB survivors, among others.
Himachal Pradesh State Minister for Health and Family Welfare Kaul Singh Thakur announced that TB will get eliminated from Himachal Pradesh by 2021-2022 – few years before India’s commitment to eliminate TB by 2025. If every Indian state moves towards ending TB before national commitment to end TB by 2025, then only India will be able to keep its promises. Likewise if every country moves towards ending TB before 2030, then only the world will be able to eliminate TB by 2030.
Member of Parliament Anurag Thakur promised to go to every other state in India mobilizing them to make their state TB free before India can eliminate TB by 2025.
Jose Luis Castro, Executive Director of the International Union Against TB and Lung Disease (The Union) agreed: “To end TB in the world we must first end TB in India.”
MP Anurag Thakur quoted Prime Minister of India: “Correct and complete treatment of the disease [TB] is important to cure it.” MP Anurag Thakur stressed that although the TB programme began in 1962 but it still killed 480,000 in 2015. “These numbers should shock us in taking immediate and collaborative steps” said Anurag Thakur at the TB Free India Summit.
Rajiv Pratap Rudy, Minister of State (Independent Charge), Ministry of Skill Development and Entrepreneurship, Government of India, who till last year had the additional charge of Parliamentary Affairs Ministry, shared at the TB Free India Summit that two people close to him had got diagnosed with TB disease and eventually both got cured. One of them was his relative and the other person was among his staff.
India’s national Minister for Health and Family Welfare JP Nadda said at the TB Free India Summit that the fight against TB under the Revised National TB Control Programme (RNTCP) has come a long way in India and helped save lives. We cannot turn a blind eye on the fact that despite successes of RNTCP there are so many people suffering and dying of TB even today. We have a long way to go but with an aggressive strategy we will end TB by 2025.
JP Nadda shared that the National Health Policy (NHP 2017) released by India recently, aims to increase domestic health funding to 2.5% of GDP (from 1.2% currently). We also need to ensure that every state is fully utilizing the allocated budget for health. There should not be any unspent money from health budget, he said.
Nadda shared challenges confronting India’s fight against TB which included very low TB notifications from private sector despite TB was made a notifiable disease in May 2012, and unsatisfactory roll-out of Bedaquiline because of lack of optimal dispersing system. Nadda called for the need of a very active and robust system for dispersing drugs like Bedaquiline.
Looking ahead, later this year, a potentially game-changing Global Ministerial Conference is shaping up in Russia. Organized by the WHO and partners, this meeting will inform the High Level Meeting on TB at the UN General Assembly in 2018.
UNITED TO #endTB!
Risk of TB transmission as well as TB treatment outcomes both are dependent upon health systems as well as social determinants that directly influences public health. For example, malnutrition, poverty, migration, urbanization, sanitation and hygiene, gender disparities, economic and other inequalities in the society that marginalize communities, and a host of other development indices can impede TB programme outcomes.
Failure to avert every new transmission of TB infection and failing to diagnose, treat and cure every case of TB without any delay, push us backwards in our #endTB mission. We need to partner with everyone that can help prevent transmission of TB infection and help ensure early TB diagnosis, treatment and cure with ‘no one left behind’ becoming the reality on the ground.
“In the fight against TB, we need to focus more on social determinants” said Dalbir Singh, President of Global Coalition Against TB (GCAT) and a TB survivor who has been making countrywide efforts to engage parliamentarians and other sectors in the fight against TB. “Unless we address malnutrition, urban development, sanitation and hygiene, among other social determinants, we will fail to end TB” rightly warned Singh.
Agreed Dr Sunil Khaparde, Deputy Director General and head of Central TB Division, Ministry of Health and Family Welfare, Government of India: “Social determinants of TB pose big public health challenge” while calling for inter-sectoral responses to bolster the fight to end TB. Private sector engagement in TB control is very important as more than half of TB patients are going in private sector to seek care, said Dr Sunil Khaparde. There is some progress in engaging private sector in TB control after TB notification was made mandatory by the government of India in May 2012. More than 300,000 TB notifications came from the private sector but lot more needs to happen as this is indeed just the ‘tip of the iceberg’.
There are important government-run programmes on specific social determinants coordinated by a range of different government ministries and departments, as well as wide range of other development actors. Meaningful engagement of all actors, who can play a role in progressing towards ending TB, is undoubtedly a compelling public health priority.
PREVENTION CANNOT TAKE A BACKSEAT
Dr Jamie Tonsing, South East Asia Regional Director of the International Union Against TB and Lung Disease (The Union) emphasized upon the risk factors that elevate the TB risk, such as diabetes, tobacco use, HIV, malnutrition, among others. She called for scaling up collaborative programming to address these risk factors to improve TB programme outcomes.
Another expert at the TB Free India Summit, Dr Masae Kawamura, Senior Director of Scientific and Medical Affairs, Qiagen, and senior member of Vital Strategies, pointed out “Without prevention we cannot accelerate the TB decline”. Addressing latent TB has to be a part of comprehensive strategy to eliminate TB.
We cannot put latent TB on blind spot, more so in high burden countries like India, when scientific evidence abounds for its effective treatment. We need to let scientific evidence, drive policy and programmes. There is no doubt that preventing TB is among the non-negotiable goalposts on the path to #endTB!
Ensuring standard infection control in healthcare facilities as well as communities and homes cannot be ignored if we are committed to end TB.
COULD A VACCINE BE A SILVER BULLET?
We have had a TB vaccine since almost one hundred years now: BCG (Bacille Calmette Guerin) which was first medically used in 1921. It is still being used for children in high burden nations. Even though BCG is the most widely used vaccine in the world, it has not successfully eliminated TB due to its very limited (but important) efficacy. There is no doubt that research and development for new vaccines would have the biggest impact on the epidemic, and remains the cornerstone for reaching global elimination within the coming decades. “Can we have better vaccines to prevent TB? Boosting research for more effective vaccines is an important priority” said Dr Srikanth P Tripathy, Director of National Institute for Research in Tuberculosis (NIRT), Indian Council of Medical Research (ICMR).
“Till research and development pipeline gives us a new effective TB vaccine, we need to realize that we currently have a good range of evidence-based methods to prevent, diagnose and treat TB, do infection control and provide care and support. Comprehensive TB prevention, control and care programmes are our present-day ‘vaccines’ in-hand – and we must implement these as efficiently as possible” rightly said Shobha Shukla, Executive Director of CNS (Citizen News Service).
ADDITIONAL FUNDING OF USD 280 MILLION PLEDGED
Christopher Ben, Director (External Relations), Global Fund to fight AIDS, TB and Malaria (The Global Fund) said that “Finance and innovation are key and often interconnected as they may lead to each other.” The Global Fund has funded over USD 2 billion in previous years for fighting AIDS, TB and malaria in India. He announced a new additional funding of USD 280 million for TB over the next three years.
EMPOWER THOSE WITH GREATEST NEEDS
Let’s hope the 70th World Health Assembly and the new Director General of the WHO will prioritise integrated responses to boost up health security globally. As Richard Horton, Editor-in-Chief of the Lancet, tweeted “Global health is about global democracy. But today nations with the greatest needs have the least power and influence. That must change.” Let’s keep the faith burning and striving for the desired change.
WHO recently announced new recommendations to speed up diagnosis and improve treatment outcomes for multi drug resistant TB (MDR-TB)
WHO recently announced new recommendations to speed up diagnosis and improve treatment outcomes for multi drug resistant TB (MDR-TB) through the use of a novel rapid diagnostic test called MTBDRsl, and a shorter, cheaper 9-12 month treatment regimen. The new treatment regimen can be completed in 9-12 months— less than half the time required by the current 24-month treatment standard used worldwide. Continue reading MDR-TB treatment regimen: Short indeed is beautiful→
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