Three Deaths per Minute

Ousainou Sarr came to the UK from Gambia more than two decades ago. For two years he experienced typical tuberculosis symptoms – weight loss, profuse night sweats, a persistent cough – but his GP never suspected he might have TB. He was living rough on the streets of London, the TB capital of Western Europe, when the Find & Treat van offering TB screening arrived. The van is a specialist NHS outreach service that aims to tackle TB among homeless people, drug or alcohol users, vulnerable migrants and ex-prisoners across the UK, by providing screening and access to care. More than 9000 cases of TB were diagnosed in the UK last year.

I met Sarr at the World Conference on Lung Health in Liverpool last month. ‘The very first time I jumped on the van, it took less than two minutes for them to see that I have TB,’ he told me. ‘I was so happy that finally someone knew what was happening to me.’ Six months later he completed his treatment – never missing a tablet – and he now works as a TB outreach worker. ‘It’s because of the stigma surrounding TB, most people don’t want to be screened,’ he said. ‘People like me are here to encourage people to get screened.’

According to the World Health Organisation’s most recent global TB report, the epidemic is larger than previously estimated, with 10.4 million new infections in 2015, of which 60 per cent were in India, Indonesia, China, Nigeria, Pakistan and South Africa. The disease, one of the top ten causes of death worldwide, kills 1.8 million people each year – more than three deaths every minute – and drug-resistance is on the rise in many countries.

One of the Sustainable Development Goals adopted by the UN last year was to end the TB epidemic by 2030. But spending on TB this year was almost $2 billion short of the $8.3 billion needed to tackle the disease; the gap is expected to widen to $6 billion in 2020 if funding doesn’t increase. If cases of TB across Europe continue to fall at the current rate, it won’t be eliminated here till 2092. The outlook is considerably worse for other parts of the world.

‘Why don’t governments invest more in TB?’ asked Mario Raviglione, the director of the Global TB Programme at the WHO. ‘Europeans have abandoned TB research. We’re not going to win this epidemic without revolutionary tools.’

‘It’s so easy for people to say this is a problem affecting people we don’t really care about,’ said Luis Cuevas, who teaches at the Liverpool School of Tropical Medicine. ‘If we don’t confront the epidemic, we will leave this infection to fester.’