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No. 232, 19 October 2018

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The UN adopts first resolution on tuberculosis: the G77 and China statement calls for increasing resources and expanding affordable access to medicines

By Viviana Munoz Tellez and Mirza Alas

On September 26, the United Nations General Assembly adopted a political declaration of the high-level meeting of the General Assembly on the fight against tuberculosis (TB), as resolution A/RES/73/3. The Group of 77 and China delivered a statement supporting the new commitments and calling for increased resources and means of implementation by the international community towards developing countries in most need, as well as increasing affordable access to medicines, diagnostics, vaccines and other medical tools, scaling up investments in research and development and delinking its costs from the price and sales volumes of new medical tools.

Le 26 septembre 2018, l’Assemblée générale des Nations Unies a adopté la déclaration politique issue de la réunion de haut niveau de l’Assemblée Générale sur la lutte contre la tuberculose en tant que résolution A/RES/73/3Le Groupe des 77 et de la Chine a fait une déclaration dans laquelle il appuie les nouveaux engagements pris et invite la communauté internationale à accroître les ressources et les moyens de mise en œuvre fournis aux pays en développement qui en ont le plus besoin.  Il appelle également à améliorer l'accès, à un prix abordable, aux médicaments, vaccins, moyens diagnostiques et autres technologies médicales, à augmenter les investissements dans les activités de recherche-développement (R-D) et à dissocier des coûts afférents à la R-D des prix et du volume des ventes des nouvelles technologies médicales.

El 26 de septiembre la Asamblea General de las Naciones Unidas adoptó la declaración política de la reunión de alto nivel de la Asamblea General sobre la lucha contra la tuberculosis mediante la resolución A/RES/73/3. El Grupo de los 77 y China emitió una declaración en la que expresa su apoyo a los nuevos compromisos e insta a la comunidad internacional a aumentar los recursos y medios de aplicación para los países en desarrollo más necesitados, a mejorar el acceso a precios asequibles a medicamentos, diagnósticos, vacunas y otros instrumentos médicos, a incrementar las inversiones en investigación y desarrollo (I+D) y a desvincular los costos de la I+D del precio y del volumen de ventas de los nuevos instrumentos médicos.

The High Level Political Declaration on Tuberculosis (TB)
According to the World Health Organization (WHO), tuberculosis is the top infectious killer worldwide and the leading cause of deaths due to antimicrobial resistance (AMR) and among people with human immunodeficiency virus (HIV). In 2016, over 10 million people developed TB, and 1.7 million died of TB.  
In the political declaration titled ‘United to End Tuberculosis: An Urgent Global Response to a Global Epidemic’, countries have set new targets to end the epidemic by 2030. These include providing 30 million people with preventive treatment to protect them from developing TB, mobilizing US$ 13 billion a year by 2022 to implement TB prevention and care, and US$ 2 billion for research.
In the declaration, countries commit to provide diagnosis and treatment for TB, to strengthen prevention for those most at risk, to overcome the crisis of multidrug-resistant TB including working on implementing stewardship programs to prevent the development of further drug resistance. The declaration highlights that drug-resistant forms of tuberculosis are a critical challenge and the most common among antimicrobial resistance globally. Accordingly, it calls for ensuring that TB programs are part of developing national antimicrobial resistance strategies, and also to address TB in the context of child health.
The declaration further commits to the coordination and collaboration between TB and HIV programs, to find the missing people with TB, to adapt and implement rapidly the WHO End TB Strategy, to achieve and sustain universal health coverage and to strengthen public health systems.
An important inclusion in the declaration is the strengthening of support and capacity building for low-income and lower-middle income countries. In addition, the declaration includes a commitment to advance research and development efforts, in particular by supporting mechanisms that delink the cost of research and development (R&D) – by calling on countries to scale up investments - from the end price and volume of sales so as to promote affordable access to new medical technologies. It also recalled the 2001 WTO Doha Declaration ‘on the TRIPS [Trade-Related Aspects of Intellectual Property Rights] Agreement and Public Health which recognizes that intellectual property rights should be interpreted and implemented in a manner supportive of the right of Member States to protect public health and, in particular, to promote access to medicines for all, and that intellectual property rights are an important incentive in the development of new health products’.
Importantly, the declaration calls to mobilize increased financing and requests the Director- General of the World Health Organization to develop the Multisectoral Accountability Framework and the Secretary-General to provide a progress report in 2020 and to hold a high level meeting in 2023 to review progress.
Statement by the Group of 77 (G77) and China
The Group of 77 and China, represented by H.E. Dr. Hala Zayed, Minister of Health and Population of the Arab Republic of Egypt, delivered a statement after the approval of the declaration. The statement highlights the key challenges for developing countries in their efforts to eliminate TB. The G77, in recognizing the urgent need to scale up the TB response in order to achieve the Sustainable Development Goals (SDGs), calls for the strengthening of the response from prevention to treatment, which requires that the international community provides increased resources and the means of implementation to support developing countries to combat TB.
Furthermore, the statement stresses the need to ensure affordability and access to existing and new medicines, vaccines, diagnostics and other medical tools, including through the use to the fullest extent of the flexibilities provisions in the Doha Declaration on TRIPS and Public Health.  It also urges more investment in research and development of new tools, by ensuring that R&D efforts are needs-driven, evidence-based, and a shared responsibility. These efforts must be guided by the core principles of affordability, effectiveness, efficiency, and equity through delinking research and development costs from prices and sales volume. This language echoes the agreed text of the Political Declaration on Antimicrobial Resistance in 2016.
The full text of the High Level Political Declaration on TB can be found here:
Further information on the High Level meeting on TB can be found at UN meetings coverage GA/12067,
The full text of the statement by the Group of 77 and China can be accessed here:

Authors: Viviana Munoz Tellez is Coordinator and Mirza Alas is Researcher of the Development, Innovation and Intellectual Property Programme (DIIP) of the South Centre.
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