Tuberculosis (TB) has emerged as the deadliest infectious disease worldwide, overtaking HIV/AIDS in mortality rates. As this ancient scourge reclaims its position as the leading killer among infectious diseases, the global health community is on high alert. Despite being preventable and treatable, TB continues to pose a severe threat, particularly in low- and middle-income countries like Kenya, where it remains a pressing public health concern. Experts warn that without enhanced awareness and renewed political commitment, the country may lag in its efforts to eliminate TB by 2030, in line with the global Sustainable Development Goals (SDGs).
Against this backdrop, the Second Kenya National TB Champions Summit was held in Nairobi this week, bringing together key stakeholders, TB champions, advocates, and healthcare experts. The forum sought to foster collaboration, address challenges, and explore strategies to improve TB care and management. The event’s theme, “Empowering TB Champions for a TB-Free Kenya,” underscores the importance of advocacy, political leadership, and community engagement in the fight against TB.
Tuberculosis: The Silent Epidemic
TB’s rise as the top infectious killer worldwide signals a disturbing trend. According to the World Health Organization (WHO), tuberculosis caused an estimated 1.6 million deaths in 2021, surpassing HIV/AIDS in global mortality. In Kenya, TB remains a major health challenge, with an estimated 140,000 new cases reported each year, making it one of the top 10 causes of death in the country. Despite significant advances in treatment and diagnostics, TB has proven resilient, with challenges such as drug-resistant strains, underfunding, and lack of awareness hindering progress.
Philip Nyakwana, a longtime TB advocate and member of the Kenya Coordinating Mechanism for the Global Fund, TB, and HIV, underscores the significance of uniting stakeholders in the fight against tuberculosis. “This forum unites TB champions from all 47 counties to discuss TB care and management, primarily through advocacy. Such a forum generates important information used in decision-making,” he said during the summit.
The challenge, as Nyakwana points out, is multifaceted. While advocacy has brought progress in some areas, gaps remain in the overall approach to TB care and management. These gaps include underfunding, lack of awareness, stigma, and insufficient political commitment. The summit provided a platform to address these issues and generate solutions that can be implemented at both the national and county levels.
The Role of Political Commitment
One of the key challenges in the fight against TB is the lack of sustained political commitment. Evaline Kibuchi, Chief National Coordinator of Stop TB Partnership Kenya, emphasized the crucial role that political leadership plays in addressing the TB crisis. “TB has overtaken HIV in mortality rates both in the country and globally, making TB the most infectious killer disease. I long for the day when the president will stand on a podium and declare that we are losing people to a treatable disease, committing to leadership in addressing this problem,” she said.
Kibuchi’s call for greater political leadership reflects a broader issue in the global fight against TB. Despite the clear threat posed by the disease, political will and resource allocation often fall short of what is needed to achieve the SDG target of eliminating TB by 2030. Countries like Kenya, which have a high burden of TB, need to prioritize the disease at the highest levels of government, ensuring that sufficient resources are allocated for prevention, treatment, and research.
Political commitment must go beyond rhetoric and be reflected in tangible actions, such as increased funding, policy reforms, and public health campaigns. In Kenya, health services have been devolved to county governments, but as Kibuchi points out, counties often do not allocate specific funds for TB treatment, leaving the responsibility to the national government. This disconnect between policy and practice hinders progress and leaves many vulnerable populations without access to proper care.
The Funding Gap
One of the most pressing challenges in the fight against TB is the persistent funding gap. Globally, funding for TB prevention and treatment falls far short of what is needed to meet the 2030 elimination goals. In Kenya, the situation is no different. According to Kibuchi, domestic funding for the TB response is only 34%, while donor funding accounts for about 66%. This reliance on external donors creates a precarious situation, particularly as global donor funding shrinks due to shifting priorities and economic pressures.
“With shrinking donor funding, what will happen if the donors withdraw, yet the government only commits 34%?” Kibuchi asked during the summit. Her concern highlights the urgent need for Kenya to increase domestic funding for TB programs and reduce its dependence on foreign aid. Without a sustainable funding model, the country’s TB elimination efforts are at risk of stalling, leaving millions of people vulnerable to infection.
The funding challenge is further compounded by the high cost of treating drug-resistant TB, which requires longer and more expensive treatment regimens. Multi-drug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) have emerged as significant public health threats, requiring urgent attention. Addressing the funding gap will require innovative financing solutions, such as public-private partnerships, increased domestic resource mobilization, and better integration of TB programs into broader health systems strengthening initiatives.
The Importance of Awareness and Education
Another critical area in the fight against TB is raising awareness and educating the public about the disease. TB remains shrouded in stigma, with many people unaware of its symptoms and the importance of early diagnosis and treatment. This lack of awareness contributes to the continued spread of the disease, particularly in underserved communities where healthcare access is limited.
“Until we educate 50 million Kenyans about the basic symptoms of tuberculosis and the consequences of not seeking treatment, we will never win this war. The only way we can achieve this is through sustained education via media and social media to create awareness,” Kibuchi said during the summit.
Education and awareness campaigns are essential for reducing stigma and encouraging people to seek care early. Such campaigns should leverage both traditional media and digital platforms to reach a wide audience, particularly in rural and marginalized communities. Health education programs in schools, workplaces, and community centers can also play a crucial role in spreading accurate information about TB and reducing the fear and misconceptions surrounding the disease.
A Call to Action: Collective Responsibility
The fight against tuberculosis requires a collective effort from all sectors of society. As Kibuchi noted, managing TB should not be left to healthcare workers and civil society alone. It is a collective responsibility that requires the involvement of governments, private sector stakeholders, community leaders, and ordinary citizens. Only through sustained collaboration can the global community achieve its goal of eliminating TB by 2030.
In Kenya, this means prioritizing TB in the national health agenda, increasing domestic funding, raising public awareness, and strengthening health systems to provide timely and effective care to those affected by the disease. The Kenya National TB Champions Summit serves as a crucial platform for driving this agenda forward, but it is only the beginning. Continued advocacy, political leadership, and community engagement will be essential to turning the tide against TB and saving millions of lives.
Conclusion
As tuberculosis surpasses HIV in mortality rates, the urgency of the global TB crisis cannot be overstated. In Kenya and around the world, the fight against TB faces significant challenges, from underfunding to lack of political will and insufficient public awareness. However, with increased focus, renewed political commitment, and collective action, the goal of eliminating TB by 2030 is still within reach. The time to act is now—before more lives are lost to this preventable and treatable disease.
