Skip directly to content

TAG at the Union, 2008: The Impact of Activism on TB


The Union Conference provides an important opportunity for TAG to exert its activist influence on all of the key people in the fight against TB.


tagline 2009 April

By Javid Syed

The tuberculosis universe convenes once a year at the World Conference on TB and Lung Health, organized by the TB equivalent of the International AIDS Society: the International Union against TB and Lung Disease (IUATLD). This large meeting—also known as the Union Conference—is where data on TB research, programs, and policy are presented and discussed, and it provides an important opportunity for TAG to exert its activist influence on all of the key people in the fight against TB, a disease that continues to kill nearly two million people a year. The initial goal of TAG’s advocacy efforts was to increase activist participation at the Union, to create a wider understanding of the need for TB activism, and to infuse a greater sense of urgency into conference proceedings, especially on issues such as TB/HIV coinfection, TB diagnostics, multidrug-resistant (MDR) TB, and the affected by TB and HIV. TAG began its work at the Union in 2002 by organizing advocacy workshops that fostered a cadre of science-based TB/HIV activists who understood TB policies and could critique why treatment programs were failing people with HIV and MDR TB. To provide a platform for these activists, TAG began to organize panels at the Union that targeted TB control program implementers and grant makers and highlighted how activist efforts were strengthening TB control.

During the past two years, TAG’s work at the Union has evolved. With its advocacy workshops now held at least two times a year in Africa, the Union Conference has become an opportunity for TAG to convene leaders in TB research, program implementation, grant making, and activism at satellite meetings focused on priority advocacy concerns that are also pressing challenges for TB control—from MDR TB in the context of HIV to achieving universal access for TB/HIV prevention, care, and treatment. TAG’s preconference satellite meeting capitalizes on its ability to bring together diverse stakeholders who seldom talk to each other and to get them to focus on how they can and must work together to address these challenges in TB control. The presentations include concrete examples of how this collaboration has been undertaken by others, and this helps break down myths that certain interventions—such as community-based treatment for MDR TB in settings of high HIV incidence—are not possible in low-income countries. By organizing these satellite meetings and showcasing examples of effective implementation and collaboration, TAG has been able to reframe discussions to underscore what can be accomplished through political leadership and partnership—with a strong focus on the involvement of people infected and affected by TB. It is TAG’s own version of President Barack Obama’s motto “Yes, We Can!” The impact of this strategy can be seen when the examples and analyses generated at the satellite meetings are referred to throughout the rest of the ensuing conference, as participants push for faster scale-up and greater ingenuity in addressing the grave challenges to TB control that continue to make the disease the leading killer of people with HIV around the globe.

In light of the above goals, the 2008 Union Conference was a great success. TAG facilitated the participation of 40 activists in the conference, including its successful preconference satellite titled “TB/HIV Programs: Working Together to Achieve Universal Access to HIV and TB Prevention, Care, and Treatment.” This preconference meeting provided cutting edge information on how programs in resource-constrained settings were scaling up effective interventions to address TB/HIV coinfection. Some of the interventions highlighted in the satellite meeting include providing isoniazid to prevent TB disease among people with HIV and latent TB infection in the routine program settings of public HIV clinics in Rio de Janeiro, and scaling up MDR TB services through a community-based model of treatment support in the high-HIVprevalence setting of Lesotho. The success and very existence of these efforts has challenged long-standing TB dogma that essentially says such interventions are impossible to scale up in poor communities. (For a full report on the satellite and presentations click here) Discussions from TAG’s satellite meeting echoed throughout the Union, bringing to the fore the need for greater leadership by TB and AIDS programs and underscoring how these programs must harness the power of civil society if they are to successfully improve how TB/HIV and MDR TB services are provided. To download presentations from a symposium on activist-generated solutions click here.

In addition to the satellite, TAG’s leadership was vital in organizing a late-breaker session that, for the first time in the Union conference’s history, invited the leadership from ten national AIDS programs to discuss actions that such programs should undertake to fulfill their responsibilities to implement interventions to reduce the burden of TB among people living with HIV. This session was very well attended, and stimulated a lively dialogue that not only highlighted what national AIDS programs needed to do but also provided a space in which activists could share their perspectives on what was lacking in TB and HIV programs’ responses and how infected and affected communities can be engaged to help address challenges in TB/HIV program implementation. Following the success of this session, the conference organizers have committed to the inclusion of AIDS program leadership at the next Union Conference, and have already worked with TAG to organize a follow-up session at Union 2009. (For a report on the 2008 TB/HIV late-breaker session click here.)

As it has for the past three years, TAG also released its latest report tracking changes in TB research and development (R&D) investment. The report is the only comprehensive TB R&D resource tracking effort and is used by scientists and research activists to advocate for increased resources to address the inadequacy of global investment in TB. (TAG’s 2008 TB R&D Resource Tracking Report )

The Union Conference is an important opportunity for TAG to help create momentum on the global level for programs and policies that are responsive to communities’ priorities. The activities detailed in this review were catalyzed by TAG’s leadership and brought to fruition with the support of partners such as Medicines sans Frontieres, the World Health Organization, the Open Society Institute, Partners in Health, the Stop TB Partnership, AIDES (a French AIDS activist organization), the International Community of Women Living with HIV, and many individual activists. These partnerships have moved TB/HIV advocacy much farther than TAG could have accomplished working on its own. TAG also works with these partners to ensure that the impact of discussions that take place at the Union are also carried home to the national level so that research, science, policies, and programs addressing TB are put into service where they are needed most: among the people in greatest need.