Tuberculosis (TB), one of the world’s deadliest infectious diseases, is estimated to affect 508 per 100 000 inhabitants of Timor-Leste annually. The country has the second-highest incidence rate of TB in the WHO South-East Asia Region and is among the top 10 highest incidence rates in the world. [1]. While the burden of TB in the island country is not unknown or new, it is complex. Malnutrition and smoking, both having historically high prevalence rates in Timor-Leste, are the top two known drivers of the TB epidemic and contribute more than 50% of an estimated 18 new cases of TB each day in Timor-Leste. The COVID-19 pandemic has further impacted TB services leading to more than 20% decline in case notification [2], that is likely to lead to an increase in cumulative TB cases and an increase in cumulative deaths. Consequently, the immense efforts made in improving outreach of services and providing quality care made over the past two decades are under threat of derailment. To stem the rising tide of TB and ensure fructification of efforts, Timor-Leste, with WHO support, renewed its pledge to end the disease.
How did Timor-Leste do it, and how did the WHO Secretariat support Timor-Leste?
Noting that business as usual will not result in achieving the goal of ending TB, in a first-of-its-kind initiative against TB, the Ministry of Health, with technical support from the WHO Country Office in Timor-Leste, organized a pledge signing ceremony. His Excellency Prime Minister of Timor-Leste, Taur Matan Ruak, signed a pledge which envisions comprehensive support and actions to end TB in Timor-Leste. The high-level pledge signing event was attended by His Excellency Minister and Vice Minister of Health and His Excellency Minister of State Administration and Director General of Health Services along with other senior officials from the Ministry of Health and other ministries as well as the WHO Representative and the United Nations Resident Coordinator. The event was graced by ambassadors of resident embassies and members of the diplomatic corps, including country representatives of the United Nations and international agencies, members of the civil society and nongovernmental organizations, and national and international development partners. At the same time, the Prime Minister also launched the National Plan for Accelerated Actions for Ending TB by 2025. Some of the accelerated actions include introduction of “one stop mobile TB diagnostic Van, portable digital X-Ray with artificial intelligence, smart TB-medicated container kits and transition towards case-based electronic surveillance system.
“We are not satisfied with these figures in the Global TB Report, 2021 for Timor-Leste nor are we resigned to the results obtained in recent years. It is in this sense that today, as the Head of Government, we renew our unbreakable commitment to “End Tuberculosis.”
Taur Matan Ruak
His Excellency Prime Minister of Timor-Leste
Investing in the fight against TB and other diseases with a high risk of contagion is not just an expense but a wise decision by any government that desires its people and its country to succeed.
“Investing in TB makes huge economic sense with a return of 43 US dollars against 1 US dollar and so it is prudent for me to advocate for higher allocation of domestic resources. WHO is committed to extending the most scientific and actionable technical assistance and partner with all stakeholders in supporting the Ministry of Health and people of Timor-Leste in realizing their vision of Ending TB.”
Dr Arvind Mathur
WHO Representative to Timor-Leste
As the key technical partner and lead grant proposal developer for the Global Fund funding requests, WHO convened country dialogues with community representatives and other stakeholders during which recommendations were made for intensified TB control efforts through better community response and engagement. The recommendations are now among the guiding tools in the collective fight against TB even during COVID-19 pandemic.
“I was diagnosed with TB during the pandemic, but I am under medical care and continuing the treatment. I do my best to persuade friends and families to visit the nearest healthcare centre seek medical help when they suspect they have TB. I also explain to them the symptoms and what to look out for.”
Leandro Soares
TB warrior
Notwithstanding the COVID-19 pandemic, we plan to continue the outreach activity, i.e., to screen individuals and households. We are continuing with community outreach, sensitizing them so that we improve the screening rates.”
Sr Constantino Lopes
National Programme Manager, TB
This momentous milestone was preceded by progressive efforts made by the WHO Country Office to fully activate high-level leadership to drive multisectoral action to end TB in line with the WHO Multisectoral Accountability Framework to End TB. The WHO Representative played a pivotal role in reinforcing the vital importance and necessity of high-level political engagement for ending TB in Timor-Leste. Following a series of meetings between key officials from the Prime Minister’s Office, His Excellency Minister of Health and the WHO Representative, the high-level pledge signing was strategically organized on 30 September 2021 to reaffirm country’s commitment for concerted, cohesive, and collaborative actions to accelerate progress in ending TB and to ensure implementation of an accelerated plan of actions.
REFERENCE
[1] WHO. Global Tuberculosis Report 2021. https://covid.comesa.int/publications/i/item/9789240037021
[2] https://worldhealthorg.shinyapps.io/tb_pronto/
Photo Credit: © Nalda/WHO Timor-Leste
Photo Caption: His Excellency Prime Minister, together with the Minister of Health, WHO Representative and Minister of State Administration, officially launches the National Plan for Accelerated Actions for Ending TB by 2025 during a pledge signing ceremony.
