此为英文文档 who -Status update. Reaching the targets in the political declaration of the united nations general assembly high-level meeting on the fight a

2018-2022

STATUSUPDATE

REACHINGTHETARGETSINTHE

POLITICALDECLARATIONOFTHE

UNITEDNATIONSGENERALASSEMBLY

HIGH-LEVELMEETINGONTHE

FIGHTAGAINSTTUBERCULOSIS

SEPTEMBER2023

FIRSTUNHIGHLEVELMEETINGONTB

TheGeneralAssemblyhelditsfirsthigh-levelmeetingonTB,titledUnitedtoEndTB:AnUrgentGlobalResponsetoaGlobalEpidemic,on26September2018.Thisbroughttogetherheadsofstateandgovernmentaswellasotherleadersandwasprecededbyacivilsocietyhearing.InthehistoricpoliticaldeclarationoftheUNhigh-levelmeetingonTB(resolution

73/3

),MemberStatescommittedtocomprehensive,time-boundtargetsandactionstoenhanceequitableaccesstoTBservices,protecthumanrights,addressdeterminants,reducevulnerability,accelerateresearchandinnovation,andmobilizesufficientresourcestosupportthoseendeavours.ThepoliticaldeclarationalsoreaffirmedthecommitmentstoendTBenvisionedintheEndTBStrategyoftheWorldHealthOrganization(WHO)andtheSustainableDevelopmentGoals(SDGs)oftheUnitedNations(UN).

Tuberculosis(TB)remainsamongtheworld’stopinfectiouskillers.Eachday,around4000peoplelosetheirlivestoTBandaround30,000peoplefallillwiththisdisease.

Thispreventableandcurablediseaseisdeeplyrootedincommunities“leftbehind”-wherepovertyispervasiveandhumanrightsanddignityarelimited.Thedevastatingsocialandeconomicimpactonpeopleaffectedandtheirfamiliesisprofound.

Drug-resistantTBistheleadingcauseofdeathduetoantimicrobial-resistantdiseaseintheworldtodayandaglobalhealthsecuritythreat,

withhundredsofthousandsofpeopleaffected

everyyear.

GlobaleffortstocombatTBhavesavedanestimated75millionlivessincetheyear2000.However,theCOVID-19pandemic,coupledwithconflictsacrossEurope,AfricaandtheMiddleEastandsocioeconomicinequities,hasreversedyearsofprogressmadeinthefighttoendTB,andplacedanevenheavierburdenonthoseaffected,especiallythemostvulnerable.

ThisStatusUpdateprovidesanoverviewofprogresstowardsglobalTBtargetssetinthepoliticaldeclarationofthefirstUNHighLevelMeetingonTB,spanningtheperiod2018-2022.ItisbasedprimarilyondatacompiledbyWHO’sGlobalTBProgrammefromallMemberStatesinannualroundsofdatacollection.

Thepoliticaldeclarationofthe2018UNHighLevelMeetinghasbeenwidelyembracedasanimportanttooltostrengthenandacceleratetheglobalresponsetoTBandincreaseaccountabilityinthefightagainstTB.AnumberofMemberStateshadmadeimportantprogresstowardsthe2030targetssetoutintheEndTBStrategy.However,progresswasunevenamongcountriesandregions,and,forthemostpart,accesstoTBservicesandfinancingwasadverselyaffectedbytheCOVID-19pandemic.

TBTREATMENTTARGETS

2018-2022

Inthepoliticaldeclarationofthehigh-levelmeetingoftheGeneralAssemblyonthefightagainsttuberculosis,MemberStatescommittedtotreating40millionpeopleforTBbetween2018and2022,includingpeoplewithdrug-resistantformsofTBandchildren.Atotalof34millionpeopleweretreatedforTBbetween2018and2022,representing84%ofthecumulativefive-yeartarget.Globally,progresstowardsmeetingthecumulativefive-yeartargetoftreating1.5millionpeopleformultidrugorrifampicin-resistantTB(MDR/RR-TB)reached55%.ThetotalnumberofchildrenreceivingTBtreatmentwas2.5million,representing71%ofthecumulativefive-yeartargetof3.5million,althoughtheproportionofchildrenwithMDR/RR-TBwhoreceivedtreatmentremainedverylow.

TBPREVENTIVE

TREATMENTTARGETS

2018-2022

PreventionisanessentialpartoftheresponsetotheTBepidemic,butitisnotimplementedatascalethatwouldcurbit.WHOrecommendsTBpreventivetreatmentforpeoplelivingwithHIV,thehouseholdcontactsofthosewhohavebacteriologicallyconfirmedpulmonaryTBandclinicalriskgroups(e.g.peoplewhoreceivedialysis).

MemberStatescommittedtoprovidingTBpreventivetreatmentto30millionpeoplebetween2018and2022,includingpeoplewithHIVandthecontactsofTBpatients.Atotalof15.5millionpeoplereceivedTBpreventivetreatmentbetween2018and2022,representing52%ofthecumulativefive-yeartarget.MostofthesewerepeoplelivingwithHIV.

Atthesubpopulationlevel,thetargetofprovidingpreventivetreatmentfor6millionpeoplelivingwithHIVwasreachedin2020.Incontrast,only55%ofthetargetsetforthenumberofhouseholdcontactsundertheageof5receivingpreventivetreatmentwasmet.Thenumberofhouseholdcontactsaged5yearsandoverreceivingpreventivetreatmentincreasedalmostnine-foldbetween2020and2022.However,thetotalnumberremainstoolowandonly10%ofthecumulativefive-yeartargetwasmetforthissubpopulation.TheexpandedaccesstoTBpreventiontreatmentforpeoplelivingwithHIVneedstobematchedforotherriskgroupstoreduceillnessandmortalityamongthemostvulnerable.

F

T

2

UNDING

ARGETS

018-2022

Expandingcoverageofhigh-qualityTBprevention,diagnosis,treatmentandcareservicesrequiresadequateandsustainedinvestment.FundingforTBservicesinlow-andmiddle-incomecountrieswasUS$6.4billionin2018,butdecreasedtoUS$5.8billionin2022.Thisamountfallsfarshortofthetargetsetinthepoliticaldeclarationofthehigh-levelmeetingoftheGeneralAssemblyonthefightagainstTBofatleastUS$13billionperyearby2022.Overall,closeto80%offundingwasfromdomestic

sourcesin2022,similartoprevious

years.

Since2015,fundingfrominternationaldonorshasbeenaroundUS$1billionperyear,withapproximatelytwothirdsofthistotalcomingfromtheGlobalFundtoFightAIDS,TuberculosisandMalaria.TheGovernmentoftheUnitedStatesofAmericaisthelargestcontributoroffundingtotheGlobalFundandthelargestbilateraldonorforTB.

FundingforTBresearchrangedfromUS$0.9billiontoUS$1.0billionannually.However,thisamountwasjusthalfthetargetsetatthe2018high-levelmeetingoftheGeneralAssemblyonthefightagainstTBofUS$2billionperyear.Thetwolargestinvestorsfrom2018to2022weretheGovernmentoftheUnitedStatesandtheBillandMelindaGatesFoundation,whichincombinationaccountedformorethan50%oftotalfunding.

URGENTACTIONREQUIRED

TOACCELERATEPROGRESS

ThesecondUnitedNationsGeneralAssemblyhigh-levelmeetingonthefightagainstTB,heldon22September2023andbringingtogetherHeadsofStateandotherleaderstorevitalizecommitmentsandactionstoaccelerateeffortstoendTB.

UniversalaccesstoTBpreventionandcareaspartoftheuniversalhealthcoverage(UHC)agenda,multisectoralactionstoaddressdriversanddeterminantsoftheTBepidemicaspartofthesustainabledevelopmentagenda,strengtheningessentialTBservicesaspartofthepandemicpreparedness,preventionandresponseagendaandadvancingresearchandinnovationarethekeyprioritiestodrivetheEndTBagendaforward.WHODirectorGeneral’sFlagshipInitiativeonTB,supportedbycountries,par