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Remarks by Ambassador Jeanne Maloney – World TB Day Commemoration, March 24, 2021.
March 24, 2021

Honorable Minister of Health,
Principal Secretary, Ministry of Health, Dr. Simon Zwane
Member of Parliament Macford Sibandze
WHO Country Representative, Dr Cornelia Atsyor
Members of UN Agencies,
Representatives from the NGO community,
Distinguished Guests,
Ladies and Gentlemen,

It is my honor to be here today to reaffirm our commitment to eliminating tuberculosis in Eswatini and around the world, and to raise awareness about this disease. In preparing for today’s event, I was stunned to learn that tuberculosis is one of man’s oldest plagues. Human skeletal remains dating back to 4000 B.C. show evidence of TB. We all know that TB is both treatable and preventable, yet it remains one of the world’s deadliest infectious diseases. More than 1.4 million people lost their lives to this disease in 2019, including 247 souls in Eswatini. It is time to end TB.

The theme for World TB Day this year is: The clock is ticking: Ending TB in the time of COVID-19. Though we are in a global fight against the COVID crisis – the newest pandemic, we must not forget that nearly two billion people around the globe are also infected with latent TB and are at risk of developing active TB disease. This is 23% of the world’s population, including tens of millions of children, in whom TB can be difficult to detect and is often left untreated.

Time is short for the world to make good on our global TB commitments. In 2018, world leaders committed to diagnosing and treating 40 million people by 2022, including 3.5 million children; they committed to reaching 30 million with TB Preventive Treatment, or TPT, and to mobilizing financial resources to invest in research for better science, better tools, and better delivery. We have the means to break the cycle of transmission of TB disease by identifying and treating infected people. The time to act is now.

The U.S. government has invested over $600 million U.S. dollars through PEPFAR in the public health sector in Eswatini since 2004.

Our support has helped build an infrastructure that not only provides the tools for comprehensive HIV/AIDS relief, but is well-positioned to combat other infectious diseases, such as COVID and TB. And let’s not forget that TB control is a critical element of the fight against HIV and AIDS.

We are on a good path. PEPFAR supported programs in Eswatini reported a little more than 2,000 new TB cases last year, which is a 23% drop from what was reported in 2019. Indeed, this follows a pattern we have seen in recent years of encouraging declines in the numbers of people with active TB disease in Eswatini, thanks in part to the widespread use of antiretroviral therapy to treat HIV. The challenge, however, is to ensure that ALL those identified with TB receive treatment.

We must maintain our focus on Eswatini’s national response to TB through targeted prevention and treatment. It’s clear that we must find and treat more people with TB if we are going to meet the 2022 global health deadline. In 2020, despite the COVID-19 pandemic, the U.S. supported programs to initiate TPT in over 47,000 people living with HIV in Eswatini – a 46% increase over 2019 figures.

Controlling and eradicating TB requires strong partnerships. And we are grateful for the steadfast support of our implementing partners and stakeholders in this fight. Here in Eswatini, the U.S. engages with national, regional, and community partners to support coordinated TB interventions, and improve facilities and infrastructure to prevent and treat TB. At the national level, PEPFAR is committed to supporting and strengthening the National TB Control Program’s capacity for planning, coordinating, and monitoring activities.

The U.S. government stands with the government of Eswatini in pursuit of global commitments to eliminate TB. This year alone, we provided $1.5 million dollars (or 22.19 million Emalangeni) to support the roll out of new TB prevention medicines; we provided $65,000 (or 961,580 Emalangeni) to support research on TB sequencing and identifying new TB mutations. We continue to provide technical and capacity building support to establish and maintain systematic TB screening at health facilities. And, we are supporting innovations to find and prevent TB with cost effective, sustainable interventions.

Taken together, these actions are making a difference in people’s lives – and we commend all of you, and everyone, who has committed themselves, in ways both large and small, to the fight against TB. Our achievements give us the strength and inspiration to continue the fight. We are still witnessing high mortality rates, up to 11 percent, among people infected with drug-resistant TB.

We cannot truly achieve success without vigilant surveillance and action among health care providers. We must strengthen TB education and awareness among health care providers. We have the knowledge and the means to end the TB epidemic – this ancient epidemic. Now is the time to end TB in Eswatini.