As leaders convene at 2nd high-level conference on tuberculosis during the UN General Assembly 2023 on Friday, the International Rescue Committee (IRC) calls on member states and partners to focus on those most at risk to protect them, stop tuberculosis, ensure those infected receive effective treatment and rebuild the momentum of recent scientific advances to innovate and save lives.

Much progress had been made since the first meeting in 2018 but this has been slowed, stalled or reversed progress since the COVID-19 pandemic interrupted diagnosis and care. In the interim, tuberculosis cases and deaths have risen significantly. According to the most recent data, the estimated number of deaths from tuberculosis increased between 2019 and 2021 globally, reversing years of decline between 2005 and 2019. In 2021, there were an estimated 1.6 million deaths, up from of 1.5 million in 2020 and 1.4 million in 2019, and back to the level of 2017.

The IRC's experience and research shows that the burden of tuberculosis infection is often more prevalent in refugee settlement settings rather than in more established host communities due to poor living standards, high prevalence of HIV and unsanitary feeding and nutrition practices. These factors combine to put children and other vulnerable groups at risk of contracting TB infection.

In order to help vulnerable people overcome this illness and gain access to tuberculosis services and reach those most in need, the IRC has established dedicated mechanisms for early prevention, detection and elimination TB Infection across our country responses. We support health systems worldwide responding to tuberculosis, diagnosing patients from South Sudan to Uganda to Chad to Thailand to Libya to Syria. Carried out in partnership with national and subnational Ministries of Health (MoH) and other local actors, the IRC works with communities to expand access to and uptake of TB treatment and medicines, enhanced diagnostic support, case reporting, and linkages between TB and HIV care. 

Reuben Nyaora, health focal point for the IRC at the Dadaab Refugee Camp in Kenya:

“Refugees and other displaced people are among the most vulnerable populations, having the highest morbidity and mortality rates from tuberculosis. Because of extremely high malnutrition rates, particularly among children, the incidence and prevalence of tuberculosis in this group is higher than in host populations. There is a need to implement and improve TB prevention and control in refugees and displaced people globally.”

As the IRC supports global efforts to stamp out TB, we have identified the following priorities within this fight:

1. Center equity. We have had tools to detect and treat TB since before the UN was founded, yet TB has killed more people than any other infectious disease almost every year since then. We need to build on political will at every level to ensuring access to prevention, diagnostics, and treatment.
2. Focus on malnutrition.20% of TB cases can be attributable to undernutrition, more than any other TB risk (such asHIV, diabetes, smoking). Food has been described as “the tuberculosis vaccine we already have”. As climate change risks food insecurity and the displacement of communities, we need to ensure, for many reasons, but especially for TB, that nutrition is a focus.
3. Reach those most in  need. Although food may be a vaccine, we need a true TB vaccine for the 21^st century. As diagnostics improve, we need to ensure the technology, with the supply chain necessary, reaches refugees and internally displaced persons, as well as everyone at risk.