MR ENTSCH: TB is a disease that most people thought was in the past or isolated to small pockets of some impoverished countries.
It is one of the oldest human diseases and has been identified in Egyptian mummies.
My mother was inflicted with TB in the early 1960s and spent a year in the Cairns Base Hospital.
Let me assure you: it had a profound effect on my family, especially my younger siblings who didn’t see our mother for that full year.
I, for one, also assumed the disease was no longer an issue, but nothing could be further from the truth.
The reality is: TB is the largest infectious disease killer in the world.
Despite many cases being curable with a six-month treatment regime that costs less than $40, there are still more than 10 million people who contract TB every year, including one million children.
One of the greatest challenges in dealing with TB is the complexity of its treatment.
Until recently, to treat a drug-resistant TB patient, there was a requirement for that patient to take up to 25 tablets and have two injections a day for up to two years.
There is no question that this would be a challenge for a person living in the most affluent of circumstances; however, imagine the challenge for a patient living in an underdeveloped country without access to potable water.
In Australia, we enjoy a common boundary with Papua New Guinea.
The distance between the outer Torres Strait Islands and the coastal villages of PNG’s mainland Western province is less than four kilometres.
Papua New Guinea is one of the highest burden TB countries in our region with a large number of TB victims living and dying undiagnosed.
With the treaty arrangement between Australia and PNG including unrestricted family travel, we’re already seeing TB making its presence known in the Torres Strait and in my home town of Cairns.
I will also add that one of the highest burdened countries in the world is Indonesia, so we are surrounded by this dreadful disease.
There have been significant advances in the diagnosis and treatment of TB.
The development of the GeneXpert Omni testing device means a sputum sample or mouth swab can be taken and a diagnosis can be confirmed within 60 minutes via a machine no bigger than a milkshake maker.
This is a far cry from the previous testing procedures where diagnosis could take up to two months, leaving that delay in treatment.
The beauty of the GeneXpert Omni device is that it’s solar powered and rechargeable, which makes it amazingly portable.
The stark reality is that with modern travel TB can be transmitted anywhere in the world in less than 24 hours.
In fact, the only continent that has not recorded an incident of TB is Antarctica, and that’s not because of its environment, it’s because of the quarantine arrangements in Antarctica and the very heavy screening.
There is a very, very heavy burden of TB on the Inuit population in the north, in the Arctic Circle.
In treatment, the fantastic work of the TB Alliance, under the leadership of Mel Spigelman and his team, means that we are now trialling and treating with patients who have drug-resistant tuberculosis with four tablets a day and no injection.
That treatment is for six months.
They’re also working on a treatment that will see drug-resistant tuberculosis cured with one tablet per day for three months.
So there’s been amazing progress in recent times with a focus on this.
The second major achievement for the TB Alliance has been the development of a world-first oral paediatric TB medicine.
This is a game changer for treating children. Up until this point in time there was no drug treatment for children because there was a belief that TB didn’t inflict young children, so they had to break existing tablets up and try to guess the amount for treatment.
This new one, which is a syrup that children can take orally, is absolutely fantastic.
There has never been a communicable disease that has not been cured by a vaccine.
Most of us in Australia, at some stage in our lives, would have received a TB vaccine, and there will be a scar on our upper arm to prove that we’ve had it.
But, I say to you all, don’t feel protected.
The current TB vaccine, developed in 1921, is absolutely ineffective against any new strains of TB. In fact, it’s less effective than a cup full of cold water.
It is only effective, in fact, for a small number of children under the age of five.
This is an area where we need to focus.
I’d like to congratulate James Cook University in Cairns, which has, through the Australian Institute of Tropical Health and Medicine, established a research group led by Professor Louis Schofield that focuses on developing a TB vaccine.
No-one should die of TB, a disease that has been neglected for far too long.
The disease can be cured but more needs to be done.
According to the World Health Organization’s Global tuberculosis report 2017, there was an estimated 10.4 million new TB cases in 2016 worldwide.
The Asia-Pacific region is home to six countries—India, Indonesia, China, Philippines, Pakistan and Papua New Guinea—that account for 60 per cent of the total worldwide tuberculosis burden.
An estimated 1.7 million people died from TB last year, including 400,000 people who were co-affected with HIV.
Alarmingly, the report found that underreporting and underdiagnosing of TB cases continued to be a challenge, especially in countries with large unregulated private sectors and weak health systems.
Of the estimated 10.4 million new cases, only 6.3 million were detected and officially notified in 2016, leaving a gap of 4.1 million.
The report also found that for TB care and prevention investments in low- and middle-income countries fell almost US$2.3 billion short of the US$9.2 billion needed last year.
In addition, at least an extra US$1.2 billion per year is required to accelerate the development of new vaccines, diagnoses and medicines.
The United Nations has convened its first ever high-level meeting on tuberculosis due to take place in September this year in New York.
The high-level meeting is the biggest and best opportunity to raise the political priority of TB.
It is also the most significant political meeting ever held on TB and one I am proud to say that I played a part in making a reality during my three-month secondment to the United Nations last year.
This is a golden opportunity for Australia to stand up and be counted and lead the charge in the fight against TB. We are not talking about a disease in a faraway land; TB is already on our doorstep.
In conclusion, I would like to acknowledge the work of an outstanding number of NGOs who have been instrumental in supporting me in my journey on TB advocacy, including the Global TB Caucus, the Global Health Caucus on HIV/AIDS, Tuberculosis and Malaria, RESULTS International Australia, and Stop TB Partnership, just to name a few.
I would particularly like to mention and thank Sarah Kirk and Maree Nutt.
Without their ongoing support and mentoring, we would never have been able to achieve the outstanding progress we have made to date.
I would also like to thank my colleague and dear friend Julie Bishop for her ongoing support in dealing with this horrible scourge.
Through her outstanding leadership, Australia is recognised as being at the forefront of tackling this disease.
I would like everybody here today to take a few seconds to think about this: humans generally blink every three seconds; every three seconds someone in the world contracts TB.
There is one death from TB every three minutes, but it can be absolutely cured, it can be absolutely avoided and I think it’s absolutely imperative that we move on this and move on it very, very quickly, because it’s a disease that actually drives people further and further into poverty.
It usually hits the breadwinner, particularly in developing countries, which makes it impossible for them to work and therefore drives them further and further into poverty.
It is so avoidable, but, sadly—as I cough as I am speaking here today—it is the only disease that is delivered airborne, which makes it a real threat.
Believe you me, nobody is immune from this, and, unfortunately, because most people assume that this is a disease that has been dealt with, when you present, particularly in First World countries, it is the last thing they look for.
By the time they run out of options and look at TB as one of those way-out-there options, the disease is very well advanced.
So we need to stamp it out.
I also acknowledge my friend and colleague Matt Thistlethwaite for his excellent support as we worked on this together. We are getting real results, and I am very proud to say that.