Potential TB elimination failure and launch of training for next generation of health workers

8 May, 2019

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World expert warns of potential TB elimination failure and launches training for next generation of health workers

- The chances of reaching the 2050 TB elimination target are low, due to lack of recent progress.

- Advances in diagnostics, prevention and treatments, that are key, are not enough- elimination also depends on sectors beyond health to tackle poverty, food insecurity, pollution and conflict.

- New online course (https://www.qmul.ac.uk/postgraduate/taught/coursefinder/courses/201572.html) delivered by Queen Mary University of London will equip TB workers with the full suite of tools needed to work towards TB elimination.

- 'We need to tackle the political indifference towards TB, and name and blame those who are not doing the right job.'

The University of Milan and Geneva Global Health expert and former Director of the WHO Global TB Programme, Professor Mario Raviglione, told an audience at Queen Mary University of London on Tuesday that the chances of meeting the current TB elimination target are low, and is calling for a multisectoral approach that goes beyond health interventions, to end TB by 2050.

In order to train the next generation of TB specialists, Queen Mary researchers and lecturers announced the launch of the world's first postgraduate certificate

(https://www.qmul.ac.uk/postgraduate/taught/coursefinder/courses/201572.html) to focus exclusively on TB, which will be delivered across the world through online distance learning, supported by Professor Raviglione and other global TB experts.

Tuberculosis (TB) is the leading infectious disease killer and the tenth cause of death globally, affecting 10 million people a year with 1.6 million deaths, including 300,000 among people with HIV. One of the WHO and TB community goals is to achieve TB elimination by 2050, defined as less than 1 case per million people per year.

Professor Raviglione said: "At the moment, our chances of reaching the 2050 TB elimination target are very low. We're currently seeing a 1-2 per cent annual reduction of cases- at that rate, it will take us two centuries before we eliminate TB. We need to somehow reach a reduction of 15-20 per cent per year to meet the 2050 target- that's a huge 1,000 fold reduction in cases over the next 31 years.

New treatments are not enough- poverty and food insecurity need to be tackled.

The innovations and research needed to break the current trajectory of TB include better diagnostics, treatments that are safer, easier and shorter, and effective vaccines, but Professor Raviglione warned that this may still not be enough, and is calling for a multisectoral approach to end TB: "Health ministries and organisations involved in health can do a lot of things and we will always need to diagnose, treat and prevent. But elimination also depends on the achievements of so many other sectors- poverty alleviation, education, environment and social care, to name but a few.

"We need to deal with poverty and the lack of social protection- otherwise people may be unable to follow months of treatment because of medical and indirect expenditure and especially income loss. If they abandon treatment, they risk suffering and death while continuing to infect others. We also need to deal with food insecurity, malnutrition, inequality, discrimination, poor living conditions, overcrowding, pollution and wars- these are all contributing factors towards the disease that we're trying to eliminate."

World's first postgraduate TB certificate will train next generation of specialists.

To equip the next generation of health workers with the tools needed to work

towards TB elimination, Professor Raviglione strongly supported the launch

of the world's first postgraduate certificate

(https://www.qmul.ac.uk/postgraduate/taught/coursefinder/courses/20 1572.html) to focus exclusively on TB. The online distance learning course will be delivered by experts at Queen Mary University of London from September 2019.

Course co-lead Dr Simon Tiberi from Queen Mary University of London and Barts Health NHS Trust said: "To date, this is the only university certificate programme out there of its kind in the fight against TB. The certificate will help professionals apply the necessary skills which are needed to contribute towards the goal of eliminating the disease within 30 years.

"What we're aiming to do is to give a firm understanding of TB, explain what it is, how we diagnose, treat and prevent, along with modules in public health and research. Students who enrol will have a firm understanding of TB, taught by international experts in the field. We're trying to give the students not only lots of education in TB, but also the tools they need to help them work more effectively and efficiently within the national TB programmes they're involved in."

"People working in the health sector have a responsibility to understand the political landscape and advocate to the people in important positions. In my view it is absolutely essential to make sure people are trained up in these areas, and this is all covered by the course.

Online course gives accessibility to TB workers across the world. The programme will be delivered via distance learning, allowing students to study at their own pace and in their own time. The course can be completed within six months, while students are working full time in their current job. It is aimed at a wide group of people working in TB, including doctors, nurses, TB programme workers, NGOs and public health workers.

The course includes 2-3 hours of video lectures a week given by various lecturers including external guests such as Professor Raviglione. There is also a weekly live video seminar where students can interact and ask questions remotely.

The online nature of the course is intended to provide accessibility for people all over the world, who will be able to complete this course from their homes, requiring no travel and providing an educational benefit at minimal cost.

Dr Tiberi added: "A particularly exciting aspect will be the group assignments. Given the online nature of the course there could be someone from China collaborating in a group with someone from India or the UK, learning how to work together to deliver projects. We hope that this could be the start of international cross collaboration which can continue long after the course ends- something which will be vital in the fight to end TB."

Political indifference:

Speaking more broadly about TB elimination efforts at Tuesday's lecture, Professor Raviglione also discussed the high-level UN General Assembly meeting on TB in September 2018: "The recent high-level UN involvement was a historical achievement but the key now is ensuring the accountability of countries and their political leaders as well as that of all international stakeholders. Only a small number of heads of state attended the UN General Assembly meeting in New York last year. We urgently need to tackle this political indifference towards TB, and name and blame those who are not doing the right job, through a bold accountability system."

Joel Winston

Public Relations Manager (School of Medicine and Dentistry)

Queen Mary University of London

j.winston@qmul.ac.uk

Tel: +44 (0)20 7882 7943/+44 (0)7968 267 064

- If you are interested in attending Professor Mario Raviglione's talk at Queen Mary University of London's campus, then please contact Joel Winston (j.winston@qmul.ac.uk)

- More details on Queen Mary's new Postgraduate Certificate in TB, including the online application, can be found here: https://www.qmul.ac.uk/postgraduate/taught/coursefinder/courses/201572.html

- Images can be found here: http://bit.ly/2vxQpqv

- The course is co-led by Dr David Wareham (Queen Mary University ofLondon), and lecturers and steering committee members also include Professor Giovanni Battista Migliori (WHO Collaborating Centre Tradate Italy), Sir Professor Alimuddin Zumla (University College London), Professor Onn Min Kon (Imperial College), Dr Marc Lipman (Royal Free Hospital/UCL), Dr Simon Tiberi (Queen Mary University of London) and Professor Mario Raviglione (University of Milan).

HIFA Profile: Penny Gray is a healthcare writer with Penny Gray and Associates in the United Kingdom and has a professional interest in healthcare communications, writing, editing, and research.

Email address: info AT pennygray.com