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· tuberculosis,neurology

On 26 September 2018 the United Nations (UN) will hold its first High Level meeting on tuberculosis (TB) at the New York headquarters. This meeting – United to End TB: An Urgent Global Response to a Global Epidemic - will highlight the need for immediate action to advance progress towards ending the TB epidemic by 2030.

TB remains one of the top 10 leading causes of death, and it is the leading cause from a single infectious agent. In 2017 there were an estimated 1.6 million deaths from TB. In that same year, an estimated 10 million people developed TB. Unsurprisingly, the severity is most pronounced in the least developed countries. And drug-resistant TB continues to be a public health crisis, with India, China and Russia accounting for almost half the cases.

The incidence is falling about 2% annually worldwide with the fastest declines in the WHO European and African regions. However, this decline is not fast enough to meet the End TB Strategy goals.

Diagnosis and treatment averts millions of TB related deaths every year but there are large gaps in care, especially with the limited healthcare access in sub-Saharan Africa and other developing regions. It is imperative to ensure increased and sustainable financing for infrastructure, healthcare workers, and medications, along with a framework to review and track progress at regional, national and international levels. Intensified research is necessary to reach the End TB Strategy goals with priorities including a vaccine to lower the risk of infection, a vaccine to cut the risk of disease in patients with latent infection, rapid diagnostic testing and shorter drug regimens.

There are currently several treatment regimens and 12 vaccines in clinical trials.

For those countries with a low burden of TB, the focus should be on eliminating the disease with particular attention to those groups that have the highest risk of infection. This may be problematic due to increasing migration of TB infected patients to regions that have previously had a very low risk of TB.

There must be collaborative international partnerships with coordinated actions through government and non-government organizations in order to meet the 2030 Sustainable Development Goal of ending the TB epidemic.

The non-profit organization Global NeuroCare® is in Special Consultative Status with the UN ECOSOC and fully supports all efforts to achieve these goals. Director James C. Johnston, MD, JD provided recommendations for addressing the TB epidemic and other conditions at the UN High Level Political Forum earlier this year, and the 2018 Commission for Social Development.

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