Your Excellencies,

We, the undersigned members of Tuberculosis (TB) affected communities and civil society organisations, urgently request your attention and intervention to champion a strong political declaration that prioritises community leadership, human rights, and gender equality.

TB continues to be a major global health crisis, affecting millions of lives worldwide. In 2021 alone, 1.6 million people died from TB, including 187,000 people with HIV. An estimated 10.6 million people fell ill from TB and 4.2 million out of them were undiagnosed or not reported.To end TB, as outlined in the WHO End TB Strategy and the Global Plan to End TB 2023-203014, we must identify, mitigate, monitor and overcome community, rights, gender and stigma related barriers – an area that has been historically neglected by the TB response. Putting people at the heart of the TB response is critical for ending TB. A rights-based and gender-sensitive TB response is both an ethical imperative and a pillar of public health. The political declaration must not fall short of adequately addressing these concerns.

To accomplish this, firstly, the language throughout the political declaration must be ambitious and not intentionally lacking in substance. Language such as “strive”, “up to” or “working towards reaching” targets is a regression in commitments already laid out and agreed to in existing strategies, plans, and declarations. Member states must “commit” and agree to “reach” ambitious targets.

Communities affected by TB possess invaluable insights, experiences, and innovative solutions that can greatly contribute to the development and implementation of policies and programs. It is important that the political declaration upholds their human rights and recognizes and supports the meaningful involvement and leadership of TB affected communities throughout the entire TB response, including in decision-making processes, planning, implementation, and monitoring and evaluation

Furthermore, gender equality is essential to combating TB and achieving sustainable development. The political declaration must explicitly acknowledge the gender disparities in TB and commit to addressing them through targeted interventions, such as promoting access to gender-responsive and gender-sensitive healthcare services, empowering gender minorities, and combating gender-based violence, stigma, and discrimination.

To ensure a political declaration with commitments to action that work for TB affected communities and civil society, we request your support with securing the following key asks for the final version of the political declaration:

1. Clear, measurable targets on diagnosing and treating people with TB, provision of preventive therapy, and a focus on high-risk groups, including children and people living with co-morbidities, building on commitments agreed by the General Assembly in the 2018 Political Declaration on TB and Stop TB Partnership’s Global Plan to End TB 2023-2030. 
2. Commitments that explicitly support the human rights of people affected by TB, within national and subnational TB responses that are equitable, inclusive, gender-sensitive, rights-based and people-centred, and that include action-oriented efforts to address stigma and discrimination and overcome barriers to accessing care and prevention.
3. Include a clear and measurable target to develop country-level Community, Rights and Gender costed plans, to end stigma, implement community led monitoring and fully fund affected communities to undertake this work.
4. A prioritisation to accelerate the research, development, roll-out and access to new TB vaccines, diagnostics, drugs and other essential new tools, including digital health technologies geared to the needs of the most neglected, key and vulnerable populations, including but not limited to pregnant women, children, and people living with HIV.
5. The inclusion of clear financial targets for the TB response and for research which will articulate the overall funding need, and highlight the responsibility of each country to deliver its fair share of the global funding need, as well as recognize with dedicated financial support the critical role of affected communities and civil society in the TB response.
6. Provisions for an accountability framework that includes annual reporting from the Secretary-General to monitor and evaluate progress towards ending TB and of investments in TB R&D, and that promotes and supports community led monitoring, which is essential for accountability. 

Incorporating these recommendations into the political declaration, will make it bold, ambitious, yet realistic, evidence-informed and, most importantly, conducive to ending TB by 2030 as envisaged by the Sustainable Development Goal 3. 

We look forward to your leadership and commitment to prioritising community leadership, human rights, and gender equality in the final political declaration. Together, we can make a difference and overcome the challenges posed by TB, ensuring a healthier future for all.

Thank you for your attention to this matter.

Sincerely,

Annex 1: Stop TB Key Topics Explainer Brief for UN Member States

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