Goa To Munich: Growing Call For 100-100-100 To End TB And End AIDS Before 2030

Over 1500 people from 73 countries are unequivocally
demanding that all people with HIV or TB must have access to
full cascade of standard health services and social support
in people-centred, rights-based and gender transformative
ways. Unless best of WHO recommended prevention,
diagnostics, treatment, care and support reaches everyone in
need globally, we cannot end TB or AIDS.

Call for
100-100-100 to end TB and end AIDS by 2030 or
earlier

This call for 100-100-100 was given at the
AIDS 2024 (25th International AIDS Conference, Munich,
Germany) Affiliated Independent Event organised on 4th of
July 2024 in a special session where Goa Declaration was
launched (read about Goa Declaration below). Goa Declaration
calls for accelerated response to meet SDG target of #endTB,
we must find all TB, treat all TB, and prevent all TB
through people-centred and rights-based
approaches.

Leave no one behind mantra

If we
are to end AIDS, we must ensure that along with 100-100-100
(100% of people with HIV knows their status, 100% of people
with HIV are on lifesaving antiretroviral therapy, and 100%
of them are virally suppressed), we also have to ensure that
no one suffers or dies of TB. According to WHO, “people
living with HIV who have an undetectable viral load using
any WHO-approved test and continue taking medication as
prescribed have ‘zero risk’ of transmitting HIV to their
sexual partner(s).” Undetectable equals untransmittable
(#UequalsU) must become a reality for everyone with
HIV.

We must ensure that 100% people with HIV know
their TB status (on an ongoing basis), 100% of those with
active TB disease are treated with medicines that work on
them, and 100% of them are using a full range of appropriate
combination prevention options to stop further spread of TB
and HIV infections.

Also, 100% of those people with
HIV who do not have active TB disease, must be offered TB
preventive therapy (to reduce the risk of latent TB to
convert into active disease).

Treatment is also
prevention (in case of both TB and HIV) as it stops the
spread of infection soon after initiation of treatment with
effective medicines. Latest HIV and TB treatment regimens
and prevention options must be accessible to
all.

Additionally, we must advance stronger action
towards #endHunger, #endTobacco, #endAlcohol,
#preventDiabetes, #NCDs, and other risk factors associated
with TB.

People-centred, rights-based and gender
transformative approaches remain the bedrock to advance
health programmes – including those for TB and HIV. Zero
catastrophic cost, zero HIV and TB stigma (and self-stigma)
and discrimination must be a reality for all.

This
14-hour hybrid AIDS 2024 Affiliated Independent Event was
jointly co-hosted by 35 organisations worldwide and engaged
over 1400 people from 73 countries. Co-hosts included: AVAC,
UNAIDS Asia Pacific, International Community of Women Living
with HIV (ICW), Global Network of People living with HIV
(GNP Plus), Y+ Global, Y-PEER Asia Pacific, Society for AIDS
in Africa (SAA – official secretariat of International
Conference on AIDS and STIs in Africa – ICASA), APCOM,
Zimbabwe National Network of People living with HIV (ZNNP+),
Prevention Access Campaign, National Coalition of People
living with HIV in India (NCPI Plus), AIDS Society of India
(ASI), Ivorian Network of People living with HIV (RIP+ in
Cote d’Ivoire), Cheyutha, Botswana Network on Ethics, Law
and HIV/AIDS (BONELA), National Empowerment Network of
People living with HIV/AIDS in Kenya (NEPHAK), MPLUS
Foundation Thailand, KHANA (Khmer HIV/AIDS NGOs Alliance)
Cambodia, Americas TB Coalition, TB People (Global), TB
People (Nepal), TB People (Zimbabwe), TB People (India), TB
People (Botswana), Humana People to People India, Rekat
Peduli Foundation Indonesia, Pahal Foundation, People’s
Health Organisation (PHO), Health TV Online Nepal, Asia
Pacific Cities Alliance for Health and Development (APCAT),
Asia Pacific Media Alliance for Health and Development
(APCAT Media), Union South East Asia Trust (USEA Trust),
Global AMR Media Alliance (GAMA), and CNS.

Goa
Declaration

to meet SDG target of #endTB, we must
find all TB, treat all TB, and prevent all TB through
people-centred and rights-based approaches

Goa
declaration has been endorsed by 107 people from the
following 38 countries worldwide (as of 13 July 2024):
Bangladesh, Benin, Burkina Faso, Cameroon, Democratic
Republic of the Congo (DRC), Congo, Eritrea, Ethiopia,
Ghana, India, Cote d’Ivoire, Jordan, Kenya, Kyrgyzstan,
Malawi, Myanmar, Nepal, Nigeria, Peru, Philippines, South
Africa, Sri Lanka, Tanzania, Chad, Togo, Uganda, Vietnam,
Zambia, Zimbabwe, Costa Rica, Ecuador, Pakistan, Japan,
Rwanda, Indonesia, USA, Lesotho, and Thailand.

Tariro
Kutadza, who leads TB People (Zimbabwe), said in AIDS 2024
Affiliated Independent Event on TB and HIV that Goa
Declaration was launched by the delegates who participated
in the “United against TB: Accelerated action towards
achieving SDG on tuberculosis” meet held in Goa, India
(15th – 17th May 2024). Since then, many more people from
around the world have endorsed the Declaration on an ongoing
basis.

Goa Declaration recognises that ending TB by
2030 is a public health and human rights imperative, as well
as critical to advance progress on other UN Sustainable
Development Goals (SDGs) and targets.

Tariro puts on
spotlight the promises made by world leaders as part of the
UN SDGs (to be met by 2030) and Political Declaration of UN
General Assembly High Level Meeting on TB in 2023 (to be met
by 2027).

Dr Samantha Tinsay, Municipal Health
Officer, Bantayan Municipality, Cebu, Philippines shared few
of the recommendations of Goa Declaration in AIDS 2024
Affiliated Independent Event on TB and HIV:

Wider
scale up of the pilots of introducing new tools project
(iNTP) of Stop TB Partnership and USAID that have shown
impact in terms of finding more TB cases and linking them to
care in a time bound manner.

Prioritising taking WHO
recommended point-of-care TB screening and diagnostic tools
to the people’s doorstep, over optimising existing
centralised or semi-centralised or lab-dependent tools or
models which often have access barriers, result in
diagnostic delays, catastrophic costs, and drop out of
people from the care cascade.

Catherine Murombedzi of
TB People (Zimbabwe) and a noted health journalist shared
the following recommendations of Goa Declaration in AIDS
2024 Affiliated Independent Event on TB and
HIV:

Effectively engaging communities in the response
to TB at every level. TB survivors, affected communities,
and community health workers bridge a deadly divide between
existing services and most-at-risk
populations.

Community-led monitoring is another
evidence-backed method to engage communities in TB
programmes meaningfully as well as improve the service
uptake from people’s point-of-view. We must listen to the
people and communities we serve. Community leadership is
also pivotal for demand generation for equitable access to
the full range of TB services.

Phasing out upfront use
of microscopy completely and replacing it with WHO
recommended molecular tests.

Increasing TB testing for
children with samples that do not depend on sputum only (for
example, stool or other methods).

Effectively
integrating TB programmes with other health and development
programmes, such as those on HIV, NCDs, HCV, harm reduction,
nutrition, tobacco control, among others.

Tarit
Chakraborty from TB People (India) shared the following
recommendations of Goa Declaration in AIDS 2024 Affiliated
Independent Event on TB and HIV:

Screening everyone
for TB regardless of symptoms in high burden settings. With
an alarming number of TB prevalence surveys showing that a
large number of people with TB are asymptomatic, it is
imperative to find all people with TB early enough by
deploying evidence-based tools like ultraportable x-rays for
population-wide screening (regardless of symptoms) and
confirming those with presumptive TB on molecular test
upfront. – Linking all of them to care will help stop the
infection-spread. Increasing use of mobile/ outreach clinics
for population-based screening will help. Where appropriate,
intensified TB screening of everyone (regardless of
symptoms) should be done in private sector facilities
too.

•  Making same day ‘test and treat’ a
  reality for everyone with TB including Key and Vulnerable
  Populations.
•  Optimally leveraging upon public
  private mix approaches to engage all healthcare providers in
  TB responses should be prioritised.

Dr Tin Maung
Htwe, a senior journalist and editor from Myanmar shared the
following recommendations of Goa Declaration in AIDS 2024
Affiliated Independent Event on TB and HIV:

Ensuring
that universal and upfront drug susceptibility testing (DST)
is a reality for every person diagnosed with TB. Doing
universal DST will also increase diagnosis of drug-resistant
forms of TB, prevent the spread of drug-resistant strains,
reduce human suffering and untimely deaths. It will also
reduce diagnostic delays and catastrophic costs. We appeal
to the world leaders who will meet at the United Nations
General Assembly High Level Meeting on Antimicrobial
Resistance (AMR) to scale up response to drug-resistant
TB.

Following up with those who are cured of TB or who
have completed the treatment with regular screening as per
the guidelines.

Tapping into extra budgetary resources
to fill the funding gap so that the response to find all TB,
treat all of them and prevent transmission is fully funded,
along with TB R&D for new safe and effective
tools.

Nurul Islam Hasib, President of Diplomatic
Correspondents Association of Bangladesh and senior
journalist with Dhaka Tribune shared the following
recommendations of Goa Declaration in AIDS 2024 Affiliated
Independent Event on TB and HIV:

– People-centric,
rights-based and gender transformative pathways are a
bedrock to rollout TB related screening and diagnostic
tools, treatments, social and health support, and prevention
services.

– Ending all forms of TB stigma and
discrimination is vital as it is a major access barrier and
violates human rights. TB stigma, intersectional stigma
(stigma due to TB and a range of other issues, such as, HIV,
gender diverse communities, work (such as sex work), prison
inmates, among others), and self-stigma (internalised
stigma) and all forms of discrimination must end.

–
Engaging journalists and other media actors in TB responses
as equal partners is important.

– Communication
between media, TB scientists, researchers, survivors,
advocates, programme managers at all levels, other
stakeholders will help to keep them informed, involved, and
supported. Media should help increase accountability and
transparency in TB responses on the ground. Simplifying TB
science and TB response in a language and manner which
connects with masses is important.

Kalpana Acharya,
Editor-in-Chief of Health TV Online Nepal and former
President of Nepal Health Journalists Association shared the
following recommendations of Goa Declaration in AIDS 2024
Affiliated Independent Event on TB and HIV:

–
Preventing all further transmission of TB. TB treatment is
prevention as people with TB of the lungs who are on
effective treatment, soon become non-infectious. It is also
equally important to make the entire range of TB prevention
methods accessible to people: such as, TB Preventive Therapy
(TPT), tobacco cessation, quitting alcohol or other
addictions, preventing and controlling NCDs, nutrition,
infection control, among others.

– Making TB
Preventive Therapy available for all eligible people (such
as, contacts, people living with HIV, among others) in whom
active TB disease is bacteriologically ruled out. Leveraging
contact tracing through intensive screening among household
and other close contacts of bacteriologically confirmed
cases is vital. TPT must be made available along with full
support including counselling to complete the
therapy.

– Ensuring infection control practices in
healthcare settings, communities, and homes are fully
implemented.

Zarina Geloo, Editor of MESICA (Media
Science Café) and senior journalist from Zambia shared the
following recommendations of Goa Declaration, in AIDS 2024
Affiliated Independent Event on TB and HIV:

– Reducing
delays in translating scientific achievements into public
health gains. Roll-out of the existing latest TB screening
and diagnostic technologies, latest treatment regimens, TB
prevention methods, among others must reach everyone in
need, everywhere – without delays. Eliminating delays in
converting scientific breakthroughs (such as point-of-care
molecular diagnostics, ultraportable x-rays, new treatment
regimens) into public health gains is vital. It will also
create a pathway for rollout of upcoming health technologies
(such as new TB vaccines if found safe and
effective).

– Supporting governments to roll-out
latest treatment regimens, such as 1 month therapy for TPT,
4 months for drug-susceptible TB, and 6 months for
drug-resistant TB.

Shobha Shukla, Bobby Ramakant –
CNS (Citizen News Service)

(Shobha Shukla and Bobby
Ramakant lead the editorial at CNS (Citizen News Service)
and are on the board of Global Antimicrobial Resistance
Media Alliance (GAMA). CNS is an official media partner of
AIDS 2024. Follow them on twitter @Shobha1Shukla,
@BobbyRamakant).

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