THE ZERO DECLARATION
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ZERO TB DEATHS
ZERO NEW TB INFECTIONS
ZERO TB SUFFERING
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July 22, 2012
We are a group of activists, clinicians, researchers, implementers, foundation and government officials, and policy makers who met in Cambridge, Massachusetts, from May 30 through June 1, 2012, to focus the world’s struggle against tuberculosis (TB) on achieving zero TB deaths, zero new TB infections, and zero suffering from TB.
We commit to zero TB deaths, zero new TB infections, and zero TB suffering and stigma, because:
- TB is preventable and curable.
- The main driver of today’s unnecessary TB deaths, new TB infections, and suffering and stigma is lack of political will.
- Every country in the world has the potential to reach the goal of zero TB deaths, zero new TB infections, and zero TB suffering and stigma.
This is a cry for global action against TB. We need a new global attitude in the fight against the disease. We need to change the way we have been thinking and working. We need to properly react against this biosocial disease of enormous and unacceptable magnitude that kills millions, unnecessarily, before our very eyes and that impoverishes and degrades the lives of millions more. We need to break with old approaches that have failed to rationally use the most effective approaches to combating the disease, and mobilize sufficient political will and resources to prevent needless transmission, sickness, and death. We can accept no less than zero new TB infections and deaths.
The immensity of the challenges posed by the increasing emergence and uncontrolled spread of drug-resistant forms of TB underlines the failure of the status quo. Too many cases TB are neither diagnosed nor treated in time to avoid onward transmission. Even when drug-resistant TB is diagnosed, too often local programs are not equipped to provide proper treatment or monitoring. Most new cases of drug-resistant (DR) TB occur from person-to-person spread; a June 2012 study from China indicates that one in 10 people with TB in China have multidrug-resistant (MDR) TB, one in 120 have extensively-drug resistant (XDR) TB, and most of these newly diagnosed cases have never been treated with second-line drugs. These data from the world’s most populous country support our demand for a radical change in the global approach to the TB pandemic; they demonstrate that efforts to control DR-TB solely focused on the highest-risk patients fail to detect most cases. Fewer than 3% of those currently diagnosed with TB have drug susceptibility tests (DST) performed, and fewer than 5% of persons with DR-TB receive appropriate, DST-guided therapy. The majority of DR-TB cases—whether diagnosed or not—receive no therapy or the wrong therapy. The TB status quo fails these individuals and exposes them and their communities to unacceptable risks of onward transmission, unnecessary suffering, and avoidable death.
We are committed to working with countries, policy makers, health and program managers, researchers, and activists, to achieve the political will necessary to obtain the most rapid and sustainable reductions in new TB infections and deaths in both adults and children with the goal of zero new TB infections and deaths.
No adult or child should die of TB, a disease that has been preventable and curable since the late 1940s. We cannot be satisfied with the realization of partial goals, such as that of reducing TB deaths by 50% compared with 1990, or simply reversing the epidemic, or with strategies that purport to lead to TB elimination by 2050—long after current leaders and policy makers will be retired or gone. Rather, we must commit to zero new TB infections and deaths.
Achieving zero TB is within our reach.
With currently available medications and empowered, functioning TB programs, 95% of the world's 9 million annual new cases of drug-sensitive (DS) TB can be cured. Of the 800,000 prevalent cases of multidrug-resistant MDR-TB, at least 70% can be cured. And of the 240,000 prevalent cases of XDR-TB, at least 30% can be cured. Thus, with sufficient political will to implement universal access to high-quality testing, treatment, and care, 8,172,000 (8.2 million) people can be cured each year. A substantial proportion of TB cases cannot be cured with currently available drugs. This is a consequence of neglect of basic, known strategies to successfully treat drug-susceptible TB and to prevent transmission of drug-resistant TB, and the disastrous neglect of the development of new TB drugs over the last 40 years. However, new TB treatment regimens now in development offer the hope of quicker, easier cures for both adults and children, regardless of TB drug resistance and HIV coinfection: at least six new drugs in four novel classes are in clinical trials today. It is likely that combinations of three or four of these new drugs can be used to treat and cure all forms of TB.
However, without a simple, cheap point-of-care (POC) diagnostic test and early and appropriate treatment based on DST, the promise of these new drugs and regimens will be rapidly lost.
Intensified investment in tuberculosis research and development will be an essential element of getting to zero. The world spends less than one-third of the annual US$2 billion that the Stop TB Partnership estimates is required to discover and develop the new diagnostics, drugs, and vaccines necessary to fully eliminate TB. We recognize four critical requirements for reaching zero deaths, new infections, and suffering. First, the development and testing of a cheap, accurate, instrument-free POC diagnostic test for all forms of TB disease; second, safe and affordable shorter-course curative TB regimens to treat all forms of TB infection and disease; third, a successful TB vaccine; and fourth, all of these recommendations need to be supported by a commitment to social justice and to tackling directly the health and economic disparities that fuel the spread of TB worldwide. Governments in rich countries and those with large TB epidemics must rapidly intensify their investment in TB R&D. The goal of zero new TB infections and deaths increases the urgency for increased investment and more rapid development of new TB drug regimens, diagnostic tests, and vaccines.
Zero new infections.
One of the ages-old challenges of TB is its ability to cause a quiet infection without making that person actively sick. For some people, disease develops years later, allowing a TB outbreak to span generations. However, TB programs can interrupt this transmission by diagnosing every case of latent TB infection and every case of active TB disease. People with TB need affordable, accessible, POC diagnostic tests to detect TB and drug resistance in households and communities. We need to scale up availability of promising new rapid diagnostic tests by making them affordable and accessible in areas lacking electricity. Moreover, a true instrument-free, non-electric and cold-chain-dependent POC test is urgently needed to diagnose all forms of TB in adults and children, regardless of TB drug resistance and HIV coinfection.
Zero suffering.
TB attacks the most vulnerable. It is the leading cause of HIV-related morbidity and mortality, killing 350,000–450,000 people with HIV each year. Currently half of TB patients are tested for HIV, and half of HIV patients are screened and tested for TB. In coinfected patients, studies have proved that use of antiretroviral therapy significantly reduces TB infection in individuals and their communities, and reduces TB mortality. We must ensure that HIV-positive persons who are exposed to and infected by M. tuberculosis (but are not actively sick) receive lifesaving isoniazid preventive therapy (IPT) to prevent active TB. Getting to zero deaths means diagnosing and curing all cases of TB in people with HIV, and treating all cases of HIV in people with TB/HIV coinfection with immediate/early antiretroviral therapy (ART). Although some HIV medications cannot be taken with TB drugs, many available regimens can treat both diseases simultaneously. New TB drugs and regimens will help to alleviate this. Policy, program, and practice integration including HIV and TB diagnosis, treatment, and prevention is the best and most effective way to improve outcomes for both diseases, and needs to be accelerated globally.
People who are undiagnosed and untreated and those receiving TB treatment suffer from stigma, discrimination, job loss, and the inability to care and provide for family members. This loss reverberates through and adversely affects community and national productivity and economies.
Since TB is transmitted exclusively by the airborne route, increased attention to and implementation of programs to reduce transmission by use of affordable and acceptable combinations of airborne transmission strategies are critically needed. This is a neglected area central to the reduction of TB infections and deaths, and requires combination interventions including BCG vaccination for infants, improved infection control in both health care and community settings, active case finding, treatment of latent infection, successful treatment of active disease, and cure.
We view the following elements as critical to achieving zero deaths, zero new infections, and zero suffering from TB:
I. Political Will and Commitment by Governments and Communities. Political will is the driving force that enables countries with high burdens of TB to reduce deaths, infections, and suffering. Commitment of other sectors of government beyond the health sector—and of society beyond government, including the private and nonprofit sectors, industry, and civil society—are instrumental in achieving these gains. We need to confront the social determinants of this disease that affects mostly the poor and marginalized and provide the dramatically increased resources critical to achieving this. Community engagement on all fronts is required to achieve zero TB deaths, zero new TB infections, and zero suffering from TB. For example,
- The Republic of South Africa has endorsed the goal of zero TB deaths, new infections, and stigma in its 2012–2016 National Strategic Plan for AIDS, Tuberculosis, and Sexually Transmitted Infections.
- The kingdom of Lesotho, which seven years ago lacked a functioning TB laboratory, has shown that a high-burden, low-income country can cure or complete treatment in 88% of its MDR-TB patients with zero loss to follow-up. Building on these regional successes, the Southern African Development Community (SADC) with support from many partners is rolling out plans for a subregional 14-country coordinated program to track and treat migrant workers, miners, and others who move among the 14 countries, using a health passport and common testing and treatment protocols.
- The United States, which has endorsed a strategy of TB elimination, now enjoys, after twenty years of effort, the lowest TB rates in its recorded history. This is due to the combination of political commitment, active case detection and contact tracing, preventive therapy, well-functioning treatment programs with supervision, and universal access to drug-susceptibility testing, which permits universal access to and uptake of treatment regimens designed to cure TB regardless of the resistance profile.
- Many other countries, particularly those in the middle-income range such as Brazil, China, India, Russia, and South Africa, have untapped ability to muster the political will necessary to reach zero new TB deaths, new infections, and suffering.
II. Active Case Detection and Elimination of TB Transmission. Since the 1990s, most TB programs around the world have focused on passive case detection of ill patients, many of these patients becoming progressively sicker for months. Without access to an accurate diagnosis, TB continues to be transmitted in health care, household, and community settings, including prisons, mines, and other crowded and unventilated places where people congregate. Failure to prevent transmission, and to diagnose infection and active disease early in the course of TB leads to worse outcomes including suffering and mortality, ongoing transmission, stigma, and discrimination. However, moving from passive to active case finding is feasible and acceptable to patients and communities, and will be critical to achieving zero new TB infections and deaths.
Recent results from the ZAMSTAR study in South Africa and Zambia have shown that household case finding with appropriate referrals can reduce TB by 22% in high HIV-prevalence rural and urban settings. The TB REACH initiative is proving that, by implementing innovative active case detection approaches, TB case detection among vulnerable population groups can be increased substantially. In a single year, TB REACH projects improved case detection by an average of 33%, and in some settings more than 100%. Pilot programs in rural South Africa demonstrate that integrated TB- and HIV community–based intensive case finding is feasible and acceptable and able to identify cases of HIV and both drug-sensitive and drug-resistant TB early in their course, even in remote and impoverished rural areas.
III. Family- and Community-Centered Care and Preventive Therapy to Block Onward Transmission. TB attacks the vulnerable. However, by empowering individuals and communities who can identify places where TB is transmitted and practice TB prevention strategies, every community can achieve universal case detection and contact tracing. Treatment to cure is also possible with universal drug susceptibility testing using validated rapid diagnostic tests. Cases should be detected within a month of symptom onset, and treatment started immediately and adjusted when the results of DST are available. Household, community, social networks, and occupational or correctional contacts (including children) of people with TB disease must be screened for active disease and latent TB infection and provided with appropriate treatment for TB or IPT. Many countries already acknowledge the importance of IPT in their guidelines, yet have still to implement them.
Recent results from the THRio study conducted by the CREATE consortium show how it is possible to implement IPT in a high-burden, high-HIV-prevalence urban setting. Other strengths of the family- and community-centered care approach include assessing all family members and close contacts of infectious cases, universal referral to appropriate treatment and cure, universal prophylaxis where needed, reducing stigma, and permitting integration of other health services, including the prevention and treatment of other infectious diseases (including HIV and malaria) and noncommunicable diseases. Achieving zero requires proactive approaches to finding and treating children, pregnant women, and mothers, as well as marginalized populations such as prisoners, migrant workers, and drug users.
IV.Intensify TB Prevention, Care, and Treatment for Women and Children, who are disproportionately vulnerable. Maternal-child health programs and integrated management of neonatal and child illness programs are well-placed to better incorporate TB prevention, diagnosis, treatment, and cure as part of primary care.
Now, in 2012, the time is right to demand and to achieve zero deaths from TB, zero new infections, and zero suffering and stigma. It is high time to roll out known strategies and demand access to new medications, diagnostics, and vaccines in the development pipeline. We call on countries and communities everywhere to commit, with urgency and immediacy, to working for zero TB deaths, zero new TB infections, and zero TB suffering.
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For more information, send us an email.
Organization Signatories as of April 22, 2013:
A.O."Adolescentul", Moldova
ACT (Alliance to Control Tuberculosis) - INSPIRE R8, Philippines
ACTION, USA
Action Secours Ambulance (ASA), Haiti
Advanced Community Health Care Services Namibia (CoHeNa), Nambia
Africa Coalition on TB (ACT!), Africa
Aid Organization (AO), Bangladesh
AIDS Information and Support Center, Estonia
AIDS Tugikeskus (AIDS Information & Support Centre), Estonia
Albert Einstein College of Medicine, USA
All-Party Parliamentary Group on Global Tuberculosis (UK Parliament), United Kingdom
Alternative for India Development, India
Área de Salud Integral, VIH/Sida e ITS de la Asociación LGBTI Algarabía, Spain
Arora's Healthcare and Education Foundation, Pakistan
Asociatia Obsteasca “TINERII PENTRU DREPTUL LA VIATA”, Moldova
Associacio de Planificacio Familiar de Catalunya i Balears, Spain
Association "STOP TB" Lithuania, Lithuania
Association d'Assistance au Developpement (ASAD), Cameroon
Association of Substitution Treatment Advocates of Ukraine (ASTAU), Ukraine
Aurum Institute, Johannesburg, South Africa
Bangladesh Lung Foundation, Bangladesh
Batho Pele Community Services Organisation, South Africa
Bathopele Community Service Organization, South Africa
Baylor Black Sea Foundation (FBMN), Romania
Bill Sullivan-Ray of Hope Foundation, USA
Blossom Trust, India
Bureau d'Etude pour la Formation, l'Organisation, la Recherche Conseils en Entreprise, Burkina Faso
Case Western Reserve University, TB Research Unit, USA
Center for Health Policy and Studies (PAS Center), Moldova
Center for Research Excellence in Tuberculosis, Australia
Centre for Youth Development and Social Empowerment (CYDSE), Malawi
Centro de Educação Sexual (CEDUS), Brazil
Centro de Promoção da Saúde, Brazil
Centrul Educaţional alcoolismulşi narcomania, Moldova
CF "VIRTUS", Ukraine
Chanchal Janakalyan Samity, India
Charitable organization "Maybutne Club", Ukraine
Chichetkelo Outreach Partners, Zambia
Coalition of People Fighting HIV/AIDS, TB and Malaria in Kenya (COPFAM), Kenya
Comitè Primer Desembre-Plaaforma Unitària d'ONG-Sida de Catalunya, Spain
Communicable Diseases Unit, HMC, Qatar
Community and Family Aid Foundation, Ghana
Community Initiative for TB, HIV/AIDS & Malaria (CITAM+), Zambia
Consortium to Respond Effectively to the AIDS-TB Epidemic (CREATE), USA
Copilărie pentru toți, Moldova
CREDINTA, Moldova
Department of Global Health and Social Medicine, Harvard Medical School, USA
Desmond Tutu TB Centre, South Africa
Division of Leprosy, TB and Lung Disease, Kenya
Drustvo SKUC, Slovenia
Emmanuel Hospital Association, India
Environment Protection for Rural Development Organisation (EPRUDO), Uganda
Estonian Network of PLWH, Estonia
European AIDS Treatment Group (EATG), Belgium
Farijika Support Group, Kenya
FISS-MST/SIDA, Cameroon
Friends of Suffering Humanity, Ghana
Fundação Ataulpho de Paiva - FAP Liga Brasileira Contra a Tuberculose, Brazil
Fundación para Estudio e Investigación de la Mujer-FEIM-, Argentina
FÛrum ONGs Tuberculose RJ, Brazil
GHE, England
GIC CADIRE, Cameroon
Global Alliance for TB Drug Development, USA
Global Health Advocates, France
Global Tuberculosis Community Advisory Board (TB CAB), International
Good Health Educators Initiative, Nigeria
Grupo de Apoio a Prevençao da AIDS, Brazil
Grupo de Trabajo sobre Tratamientos del VIH (gTt), Spain
Hamara Healthy Living Centre, Leeds, United Kingdom
Healthy Options Project Skopje (HOPS), Macedonia
HIV and AIDS Care and Support Association (HACSA), Siera Leone
HIV i-Base, United Kingdom
Hope Care Foundation, Ghana
Hope for Future Generations, Ghana
Instituto de Medicina Tropical Alexander von Humboldt, Peru
Integrated Development in Focus, Ghana
Interactive Research and Development (IRD), Pakistan
International Community of women living with HIV Eastern Africa, Uganda
International Union Against Tuberculosis and Lung Disease (The Union), France
JAGGARTA Organization, Pakistan
Janssen Research & Development, LLC, USA
Japan Anti-Tuberculosis Association, Japan
Jhpiego, an affiliate of John Hopkins University, Mozambique
Johns Hopkins University Center for Tuberculosis Research, USA
Journal Du Peuple, Benin
Journalists Against TB, India
Kaneka Rural Clinics Advisory and Nutritional Centers, Kasese (KARUCAN), Uganda
Kenya Association for the Prevention of TB and Lung Diseases (KAPTLD), Kenya
Kenya Legal & Ethical Issues Network on HIV & AIDS (KELIN), Kenya
KNCV Tuberculosis Foundation, the Netherlands
Labatec Pharma S.A., Switzerland
Laboratorio Nacional de Referencia da Tuberculose, Mozambique
Liga Científica de Tuberculose do Rio de Janeiro, Brazil
Lucane Pharma, France
Mapambano Ya Kifua Kikuu Na Ukimwi Temeke, Tanzania
Mission of Grace Ministries, Ghana
NAESM, Inc., USA
Nationa Empowerment Network of People living with HIV/AIDS in Kenya (NEPHAK), Kenya
National Tuberculosis Control Program, Mozambique
Nepal Anti-Tuberculosis Association (NATA), Nepal
New Dawn of Hope, Zimbabwe
New Jersey Medical School Global Tuberculosis Institute, USA
NGO '"AGEP'C"(ANTIHEPATITIS'C), Kazakhstan
NGO "Union of PLHIV", Russia
NGO "Volunteer", Tajikistan
NGO Opcija Ohrid, Makedonija
Nonprofit Organization of Social Support of the Population "Project April", Russia
ObservatÛrio Tuberculose Brasil, Brazil
Paneer HIV Positive Women Network Trust, India
Partners In Health (PIH), USA
PASADA, Tanzania
People Empowerment Organization (PEO), Nigeria
Pitjeng Foundation, South Africa
PLAN Health Advocacy and Development Foundation, Nigeria
Planeta Salud, Spain
Positive People Armenian Network, Soc. NGO, Armenia
Positive-Generation/Cameroon, Cameroon
PRANTIK Manobik Unnoyan Kendra, Bangladesh
Professionals For Humanity (PROFOH), Nigeria
Project Concern International (PCI), USA
Project HOPE/USAID Quality Health Care Project, Kyrgyzstan
Projeto Riscobiologico, Brazil
PSI, USA
Public organization "SPIN Plus"/Общественная организация "СПИН Плюс", Tajikistan
Public Organization "TRUST+", Tajikistan
Rainbow TB Forum (Affected Community), India
Real Opportunities Network (formerly Reliance Network), Ghana
REDE TB, Brazil
Réseau des femmes en action pour le développement social REFEADES -MAKOBOLA, DRC
RESULTS International, Australia
RESULTS UK, United Kingdom
Riders for Health, South Africa
Rural-Urban Women And Children Development Agency (RUWACDA), Ghana
Sairam Health Care Charitable Trust, india
Secretaria Municipal de Saude e Defesa Civil do Rio de Janeiro, Brazil
Sentinel Project on Pediatric Drug-Resistant Tuberculosis, USA
Sequella Inc., USA
Sewa Development Trust Sindh (SDTS), Pakistan
Shwaas Center, Navkar Hospital, India
Sinza Youth Peer Educators, Tanzania
SNEHA Foundation, India
Society Association HIV.LV, Latvia
Society for Health & Education Development (SHED), Pakistan
Society of Social Networking for Education, Health & Agriculture (SNEHA), India
Somali Welfare Organization (SWO), Somalia
South African National Tuberculosis Association JHB Branch, South Africa
St Francis Health Care Services, Uganda
Stop TB Partnership Working Group on New Drugs, USA
Stop Tuberculose BOUAKE, Cote D'Ivoire
Suvadi Inc., Sri Lanka
Swiss Tropical & Public Health Institute, Switzerland
Sydney Emerging Infections and Biosecurity (SEIB), Australia
Tamil Nadu State Aids Control Society (TANSACS), India
TB Action Group (TBAG), United Kingdom
TB Alert, United Kingdom
TB Centre, London School of Hygiene and Tropical Medicine, United Kingdom
TB Europe Coalition, Belgium
TB Investigation Unit of Barcelona, Spain
TB Network Oyo State Chapter, Nigeria
TB/HIV Care Association, South Africa
TBmanifesto - a division of FSmanifesto, Saudi Arabia
Thai AIDS Treatment Action Group (TTAG), Thailand
The AIDS Support Organisation (TASO), Uganda
The Centre for Research Excellence in Tuberculosis, Sydney, Australia
The Lancet, United Kingdom
The Norwegian Heart and Lung Patient Organization (LHL), Norway
The Tuberculosis Survival Project, United Kingdom
The University of Sydney, Australia
Tineretul Pozitiv (Позитивная Молодежь), Молдова
Treatment Action Group (TAG), USA
Tuberculosis Association of Kerala, India
UK Coalition to Stop TB, United Kingdom
Universal Versatile Society, India
Vijana Amani Pamoja, Kenya
Vivir. Participacion, Incidencia y Transparencia, A.C., Mexico
Women and Youth Development Initiatives (WOYODEV), Nigeria
Womenplus Against TB and HIV in Kenya, Kenya
World Vision US, USA
Wote Youth Development Projects, Kenya
Благотворительная организация "Всеукраинская Лига "Легалайф", Украина
Благотворительный Фонд " Вектор допомоги", Украина
Вінницьке обласне відділення ВБО "Всеукраїнська мережа ЛЖВ", Україна
ВРОО "ПОЗИТИВНАЯ ЖИЗНЬ", РФ
Кировоградская областная благотворительная организация "Открытое сердце", Украина
Кировоградское областное отделение ВБО "Всеукраинская сеть ЛЖВ", Украина
Криворожское городское отделение Всеукраинской благотворительной организации "Всеукраинская сеть людей живущих с ВИЧ", Украина
Луганское областное отделение Всеукраинской благотворительной организации "Всеукраинская сеть людей живущих с ВИЧ/СПИД", Украина
Марворид, Душанбе, Таджикистан
Медицинское Управление Департамента Пенитенциарных Учреждений Министерства Юстиции, Республика Молдова
Международный благотворительный фонд "Вертикаль", Украина
Национальная Сеть Ассоциация "Единство людей, живущих с ВИЧ", Кыргызстан
НПО "ДИНА", Республика Таджикистан
Общественная организация "Центр демократического развития", Украина
Общественный Фонд "Здоровье для всех", Кыргызстан
ОМО "Клуб взаимопомощи "Жизнь+", Украина
ОО "Доверие+", Таджикистан
ООО "Волонтёр", Республика Таджикистан
ОЮЛ "Ассоциация СПИД-сервисных НПО Кыргызской Республики "АнтисПИД"", Кыргызстан
ПМ БО "Обериг", Украина
Сообщество ЛЖВ, Узбекистан
Черкасское областное отделение ВБО "Всеукраинская Сеть ЛЖВ", Украина
ЧОГО "Позитивне життя", Україна
эстонская сеть людей живущих с вич, эстония
Individual Signatories as of April 22, 2013:
Sufyan Abdulber, Federal Ministry of Health, Ethiopia
Hussein Abdur-Razzaq, Lagos State TB and Leprosy Control Programme, Nigeria
Saddiq Abdurrahman, Department of Public Health, Health and Human Service, Abuja, Nigeria
Sarita Aguirre García, Programa Nacional de Control de la Tuberculosis, Paraguay
Koldo Aguirrebengoa, Osakidetza-Servicio Vasco de Salud, Spain
Faiz Ahmad Khan, McGill University, Canada
Heather Alcock, United Kingdom
Nunuu Ali, Ministry of Health - Pemba, Tanzania
Nyende Ali, St Francis Health Care Services, Uganda
Tânia Almeida, Universidade do Estado do Rio de Janeiro, Brazil
Pedro Almeida Da Siva, Universidade Ferederal Do Rio Grande - Furg, Brazil
Andrei Altdorf, Convictus Estonia, Estonia
Ivana Alvarez, University of Buenos Aires, Argentina, Argentina
Erika Alves, Brazil
Farhana Amanullah, Indus Hospital TB Program and International Research and Development, Pakistan
Emmanuel André, Uclouvain & Interactive Research and Development, Belgium/DRC
Petre Angelov, ZONA - Kavadarci, Macedonia
Koya Anil, TB Alert India, India
Nebreda Anna, Spain
Mercy Annapoorni, India
Oleg Antipin, Credinta, Moldova
Francis George Apina, Network of Men Living with HIV and AIDS in Kenya (NETMA+), Kenya
Jucara Arabe, Instituto de Pesquisa Clinica Evandro Chagas (IPEC-FIOCRUZ), Brazil
Carla Araujo, Universidade Federal do Rio de Janeiro (UFRJ), Brazil
Alla Asaeva, FAR, Russia
Alena Asaeva, Russia
Achidi Asanga Zaccheus, National TB Control Program (NTP), Cameroon
Janna Ataiants, USA
Rifat Atun, Imperial College, London, United Kingdom
Christian Auer, Swiss Tropical and Public Health Institute, Switzerland
Yu Nandar Aung, Sydney Medical School, Myanmar
Ayodele Awe, World Health Organization, Abuja, Nigeria
Samir Bahnasy, Pulmonary Rehablitation Center, MOH, Kuwait, Kuwait
Maradona Barbosa, Brazil
Antigone Barton, Center for Global Health Policy, USA
Aparna Barua, RESULTS, United Kingdom
Anton Basenko, Association of Substitution Treatment Advocates of Ukraine, Ukraine
Mercedes Becerra, Harvard Medical School, USA
Vikarunnessa Begum, World Health Organization (WHO), Bangladesh
Vineet Bhatia, India
Carmelita Biagtan, The Lung Association of British Columbia, Canada
Gill Black, Sustainable Livelihoods Foundation, South Africa
Celina Boga, Fundação Oswaldo Cruz (FIOCRUZ), Brazil
Ana Maria Bontempo Dias, Brazil
Adedayo Bose, DOTS provider, Nigeria
Kolleen Bouchane, RESULTS, USA
Sara Bowsky, USAID, Mozambique
Douglas Bruce, Yale School of Medicine, USA
David Bryden, RESULTS, USA
Inga Bulotien, Lithuania
Dickens Bwana, Mukikute TB Patient Organization, Tanzania
Laura Campbell, USA
Tatiana Pacheco Campos, Brazil
Natasha Candreva, Brazil
Gail Cassell, Department of Global Health and Social Medicine Harvard and Infectious Disease Research Institute Seattle, USA
Ana Maria Castro, Secretaria Municipal de Sa˙de e Defesa Civil, Brazil
Solange Cavalcante, Fundação Oswaldo Cruz (FIOCRUZ); Rio de Janeiro Health Department, Brazil
Merce Cazes, Spain
Paula de la Certa, Spain
Richard Chaisson, Johns Hopkins University School of Medicine, USA
Jeremiah Chakaya, National TB Control Programme, MoH Kenya, Kenya
Yrlene Cherques, Brazil
Eric Chikukwa, New Dawn of Hope, Zimbabwe
Olga Chilcevschi, Credinta, Moldova
Sunayan Chowdhury, India
Gavin Churchyard, Aurum Institute, South Africa, South Africa
Aliona Ciobanu, Мололеж за право на жизнь, г.Бэлц,Молдова
Gaël Claquin, Mozambique
Polly Clayden, HIV i-base, United Kingdom
Helen Clegg, United Kingdom
Ted Cohen, Brigham and Womens Hospital, USA
Alberto Colorado, Advocates for Health International, USA
Luc Comhaire, Damien Foundation Belgium, Belgium
Hugo Cornejo, Direccion Regional de Salud Lima, Peru
Zehelio Costalunga, Rede Nacional de Ensino e Pesquisa (RNP), Brazil
Denise Cotrim da Cunha, Brazil
Gaoussou Coulibaly, Stop Tuberculose Bouake, Cote d'Ivoire
Neyse Couto, Brazil
Luiza Cromack, Brazil
Zaina Hamunza Mutualo Cuna, Jhpiego,an affiliate of John Hopkins University, Mozambique
Jaqueline Aparecida da Rosa, Apoio,Solidariedade e Prevenção à Aids (ASPA), Brazil
Margareth Dalcolmo, Brazil
Charles Daley, National Jewish Health, USA
Peter Daley, Memorial University, Canada
Jean Dandois, Damien Foundation, Belgium
Doughman Danielle, USA
Colleen Daniels, Treatment Action Group (TAG), USA
Pamela Das, The Lancet, United Kingdom
Regina Daumas, Fundação Oswaldo Cruz (FIOCRUZ), Brazil
Aurora Dawson, TB ALERT/ TBAG, United Kingdom
Isadora De Backer, Damien Foundation, Belgium
Nikos Dedes, Positive Voice, Greece
Maria Jose del Pino, Spain
Tine Demeulenaere, Damien Foundation, Belgium
Anne Detjen, International Union Against Tuberculosis and Lung Disease (IUATLD), North America
Espe Devesa, Spain
Brett Dickson, International Organization for Migration (IOM), Cambodia
Vanja Dimitrievski, Healthy Options Project, Macedonia
Lucica Ditiu, Stop TB Partnership (STBP), Switzerland
Hedwin Kitdorlang Dkhar, Institute of Microbial Technology, India
Susan Dorman, Johns Hopkins Medical Institute and Johns Hopkins Bloomberg School of Public Health, USA
David Dowdy, Johns Hopkins Medical Institute and Johns Hopkins Bloomberg School of Public Health, USA
Benjamin Dzivenu Tsikata, Hope Care Foundation, Ghana
Cordula E., Take That TB, Germany
Sales Eduard, Particular, Spain
Wafaa El-Sadr, Columbia University, USA
Antonieto S. Evangelista, Alliance to Control Tuberculosis (ACT) - INSPIRE R8, Philippines
Aleksandr Ezdakov, Russia
Jum'atil Fajar, Informasi Kapuas, Indonesia
Anne Fanning, Stop TB Partnership (STBP), Canada
Nadja Faraone, Brazil
Rayane Cupolillo Ferreira, Brazil
Gerson Filho, Escola Nacional de Saude Publica (ENSP), Brazil
Laia Fina, Unitat d'Investigació en Tuberculosi de Barcelona, Spain
Joseph Fitchett, London School of Hygiene and Tropical Medicine (LSHTM), United Kingdom
Esther Flores Fuentes, Direccion Regional Salud Ica Equipo tecnico de la Estrategia de Prevencion y Control de la Tuberculosis, Peru
Underwood Frank, National TB Program, Fiji
Gerald Friedland, Yale School of Medicine, USA
Jennifer Furin, Case Western Reserve University, USA
Alaa Gad, ARMH, Saudi Arabia
Nathalie Garon, Canada
Nathan Geffen, Treatment Action Campaign (TAC), South Africa
Cristiane de Cassia Duarte da Silva Godinho, Brazil
Marcelo Bondi Godinho, Brazil
Jonathan Golub, Johns Hopkins Medical Institute and Johns Hopkins Bloomberg School of Public Health, USA
Marco Gomes, Canada
Vuyokazi Gonyela, Treatment Action Campaign (TAC), South Africa
Julian Gonzalez-Martin, Hospital Clinic of Barcelona-University of Barcelona, Spain
Fred Gordin, George Washington University, USA
Eduardo Gotuzzo, Universidad Peruana Cayetano Heredia, Peru
Celine Gounder, Bureau of TB Control, NYC Dept of Health and Mental Hygiene, USA
Charlotte Goyon, Global Health Advocates, France
Ria Grant, TB HIV Care Association, South Africa
Bogdan Grigoriu, University of Medicine and Pharmacy, Dept of Pulmonology, Romania
Uta Grosse, Kings College London, United Kingdom
Maíra Guazzi, Secretaria Municipal de Saúde e Defesa Civil/ Programa de Controle da Tuberculose (SMSDC/PCT), Brazil
Wanda Guimaraes, Centro de Promoção da Saúde (CEDAPS), Brazil
Shobhana Gurung Pradhan, Britain Nepal Medical Trust, Nepal
Vanessa Gutierrez Baena, Colombia
Silje Hagerup, Norwegian Heart and Lung Patient Association (LHL), Norway
Ameer Haider Babbar, JAGGARTA Organization, Pakistan
Jan Hajek, Canada
Boom W. Henry, TB Research Unit, Case Western Reserve University, USA
Roberto Hermida, Spain
Anneke Hesseling, Desmond Tutu TB Centre, South Africa, South Africa
Molly Holshouser, Center for TB Research, Johns Hopkins University, USA
Timothy Holtz, Doctors for Global Health, USA
Robert Horsburg, Boston University School of Public Health, USA
Benjamin Horsman, Visual Epidemiology Project,
Erin Howe, USA
Jennifer Hughes, Médecins Sans Frontières (MSF), South Africa
Rocio Hurtado, Brigham and Womens Hospital, USA
Khanh Huyen Pham, World Health Organization Representative Office in VietNam, Viet Nam
Maria-Jose Iglesias, Universidad Zaragoza, Spain
Rania Ismail, Jordan
Giselle Israel, Health Department of Rio de Janeiro City, Brazil; CREATE, Brazil
Hristijan Jankuloski, Healthy Options Project Skopje (HOPS), Macedonia
Ernesto Jaramillo, World Health Organization (WHO), Colombia
Coco Jervis, Treatment Action Group (TAG), USA
Jay Johnston, University of British Columbia, Canada
Perez Jorge Alberto, Spain
Cleverson José Bezerra Guedes, Universidade Estadual de Maringá, Brazil
Bertrand Kampoer, FISS-MST/SIDA, Cameroon
Joyce Kamwana, Coalition of Women Living with HIV and AIDS, Malawi (COWLHA), Malawi
Stacy Kancijanic, University Research Co., LLC (URC),
Karyn Kaplan, Treatment Action Group (TAG), USA
Saroj Kumar Kar, India
Samayog Karmacharya, UNICEF, DPRK
Vazha Kasrelishvili, Center for Information and Counselling "TANADGOMA", Georgia
Vivienne Kernohan, Zimbabwe
Salmaan Keshavjee, Harvard Medical School, USA
Aamir Khan, Interactive Research and Development (IRD), Pakistan
Saira Khowaja, Interactive Research and Development (IRD), Pakistan
Mette Klouman, Norwegian Heart and Lung Patient Organisation (LHL), Norway
Serena Koenig, Brigham and Women's Hospital, Harvard Medical School, USA
Anna Koshikova, All-Ukrainian Network of PLWH, Ukraine
Jessica Kuehne, RESULTS, United Kingdom
Indrajit Kumar, India
Indrajit Kumar, India
Vadim Kurganov, Estonia
Alexey Kvitkovskiy, The Association of Substitution Treatment Advocates of Ukraine (ASTAU), Ukraine
Egidio Langa, Ministry of Health, Mozambique
Philip Lederer, USA
Marlene Paulino Rodrigues Lene, Espaço prevenção /saúde DSTS/AIDS/TB/PV Mope liderança Marlene Paulino, Brazil
Montse León, Spain
Pamela Lewis, Lucane Pharma, France
Raul Lindemann, Estonian Network of People Living with HIV (EHPV), Estonia
Vika Lintsova, Ukraine
Line Lismont, Belgium
Laila Løchting, Norwegian Heart and Lung Patient Organisation (LHL), Norway
Simon Logan, All-Party Parliamentary Group on Global Tuberculosis, United Kingdom
Christine Lubinski, Infectious Diseases Society of America, USA
Ilie Macovei, Viata Noua, Moldova
Asif Mahmud, Institue of Epidemiology, Disease Control and Research (IEDCR), Bangladesh
Allan Maleche, Kenya Legal & Ethical Issues Network on HIV & AIDS (KELIN), Kenya
Pierre Mambrini, Lucane Pharma, France
Vinicio Nicolas Mancheno Carrillo, Red internacional de organizaciones en Salud, Ecuador
Judith Mandelbaum-Schmid, Stop TB Partnership, Switzerland
Shamim Mannan, India
Armando Mantoano, Brazil
Ben Marais, University of Sydney, Australia, Australia
Suzanne Marks, USA
Paulino Rodrigues Marlene, Espaço prevenção /saúde DSTS/AIDS/TB/PV Mope liderança Marlene Paulino, Brazil
Laura Martin, RESULTS Educational Fund/ ACTION, USA
Arikana Massiah, University College London, England
Amos Mataruse, Mozambique
Momar Talla Mbodji, Plan International, Senegal
Amy McConville, TB Action Group, United Kingdom
Lindsay McKenna, Treatment Action Group (TAG), USA
Ruth McNerney, United Kingdom
Guillamón Peris Miguel Ángel, Spain
Ann Miller, Harvard Medical School, USA
Mayank Mohan Mishra, Society of Social Networking for Education, Health & Agriculture (SNEHA), India
Samuel Misoi, Ministry of Public Health & Sanitation, Division of Leprosy, TB & Lung Disease, Kenya
Carole Mitnick, Harvard Medical School, USA
Rostislav Mitrofanov, Novosibirsk TB Research Institute, Russia
Subrat Mohanty, The UNION South-East Asia Regional Office, India
Rendi Moke, World Vision International, Papua New Guinea
Jorge Molina, Red Internacional de Organizacion de Salud, Ecuador
Aleksandrs Molokovskis, Latvia
Cèsar Mombunza, CONERELA+, Democratic Republic of the Congo
Mara E. Martinez Morant, Spain
Yulya Moskvina, Russia
Felister Mutoka, Kenya Ethical and Legal Issues Network on HIV/Aids, Kenya
Nigor Muzafarova, Technical Officer, GDF, Tajikistan
Sharon Nachman, HSC SUNY Stony Brook, USA
Carol Nacy, Sequella, Inc., USA
Mohammad Hasan Namaei, Birjand University of Medical Sciences, Iran
Dorothy Namutamba, International Community of Women Living with HIV- Eastern Africa, Uganda
Edward Nardell, Partners In Health, Harvard Medical School, Brigham & Women's Hospital, USA
Voskre Naumoska Ilieva, Healthy Options Project Skopje (HOPS), Macedonia
Silvana Naumova, Macedonia
Cecilia Nawavvu, Makerere University Joint AIDS Program, Uganda
Enouce Ndeche, Vijana Amani Pamoja, Kenya
Nguyen Viet Nhung, National TB Control Program (NTP), Vietnam
Fe Nocete, German Doctors for Developing Countries, Inc., Philippines
Emily Nyagaki, Kenya Association for the Prevention of Tuberculosis and Lung Diseases (KAPTLD), Kenya
Carol Nawina Nyirenda, Community Initiative for TB, HIV/AIDS & Malaria (CITAM+), Zambia
Rick O'Brien, Self-employed TB consultant, USA
Max O'Donnell, Albert Einstein College of Medicine, USA
Huaman Soldevilla Obdulia, Direccion Regional de Salud-Ayacucho, Peru
Matthew Ogunmodede, Community Health Information, Advocacy and Right Initiative (CHIARAI), Nigeria
Prosper Okonkwo, AIDS Prevention Initiative, Nigeria, Nigeria
Svitlana Okromeshko, PATH, USA
Obatunde Olubunmi Oladapo, PLAN Health Advocacy and Development Foundation, Nigeria
Alexandre Oliveira, Universidade Federal do Rio de Janeiro (UFRJ), Brazil
Sandra Opoku, Australia
Gloria Oramasionwu, Atlanta, GA, USA
Peter Owiti, Wote Youth Development Projects, Kenya
Peter Owiti, Wote Youth Development Project, Kenya
Carolina Pacheco, Brazil
Nesri Padayatchi, Centre for the AIDS Programme of Research in South Africa (CAPRISA), South Africa
Martin Pan, United Kingdom
Dimitrios Papaventsis, Reference Laboratory for Mycobacteria, Sotiria Chest Diseases Hospital, Athens, Greece
Ehtiram Pashayev, Public Union Against AIDS, Azerbaijan
Corey Peak, Harvard School of Public Health, USA
Paula Perdigão, Mozambique
Sara Perea Moreno, Socios en Salud Sucursal Peru, Peru
Claudia Pereira, Brazil
Virginia Perrucho, Comitê de Combate a Tb da Região Metropolitana de Salvador e HEOM, Brazil
Anastassia Peterson, Estonian Network of People Living with HIV, Estonia
Raquel Piller, Secretaria Municipal de Saude Rio de Janeiro, Brazil
Ana Gloria Pires, Bem-Estar Familiar no Brasil (BEMFAM), Brazil
Luis Portal, CONAPESALUD, El Salvador
Matt Price, Harvard School of Public Health, USA
Svetlana Prosvirina, Non-Governmental Organization "STATUS PLUS", Russia
Prem Raj P Pushpakaran, National Institute of Technology, Calicut, India
Rubens Raffo, Fórum de ong aids do RS- Brasil, Brazil
Mario Raviglione, Italy
Raveendra Reddy, PATH, India
Sheila Reeves, USA
Lee Reichman, New Jersey Medical School, USA
Carolina Reigada, Brazil
Chandrakant Revankar, Individual-Consultant, USA
Marlise Richter, Wits University, South Africa
Andaleeb Rinquest, South Africa
Caroline Robinson, RESULTS, United Kingdom
CËlia RodrÌguez, Spain
Bernice Roeland, Wellness Foundation -- AIDS Response, South Africa
Francisco Rosas, Vivir. Participacion, Incidencia y Transparencia, A.C., Mexico
Rosielma da Cruz RoseJìsúlè, Arcbo, Brazil
Victor Roy, GlobeMed, USA
Laia Ruiz Mingote, Planeta Salud, Barcelona
Stella Rumbam, World Vision PNG, Papua New Guinea
Careva Ruvinova, NGO Opcija Ohrid, Macedonia
Tomislav Ruzin, Healthy Options Project Skopje (HOPS), Macedonia
Tomislav Ruzin, Healthy Options Project Skopje (HOPS), Macedonia
Memory Sachikonye, UK Community Advisory Board, United Kingdom
Kazeem Salami, University of Ilorin Teaching Hospital, Nigeria
Mónica Yvonne Salazar Angulo, DISA II Lima SUR, Peru
Mariia Samko, International Alliance HIV/AIDS, Ukraine
Vidya Sampath, India/USA
Ataulhaq Sanaie, Anti Tuberculosis Association Afghanistan Program (ATA-AP), Afghanistan
Claudia Santos, Universidade Federal do Rio de Janeiro (UFRJ), Brazil
Valeria Saraceni, Brazil
Pappu Sarma, SMLS TRUST; AMALAPURAM, India
Carlos Savoie Pérez, Asociacón LGBTI Algarabía, Spain
Simon Schaaf, Desmond Tutu TB Centre, South Africa, South Africa
Gayle Schack, USA
Samuel Schumacher, McGill University, Canada
Kevin Schwartzman, McGill University, Canada
Barbara Seaworth, Heartland National TB Center, USA
James Seddon, Desmond Tutu TB Centre, South Africa, South Africa
Vladlena Semeniuc, Moldova
Fadeev Sergey, bf Vektor dopomogi, Ukraine
Sarita Shah, Albert Einstein College of Medicine, USA
Shiva Shrestha, PATH, India
Shobha Shukla, Citizen News Service (CNS), India
Billy Sichamba, Chichetekelo Outreach Partners, Zambia
Natalia Sidorenko, Russia
Natalia Sidorenko, Russia
Carolina Silva, Secretaria Municipal de Saúde, Brazil
Maria das MercÍs Duarte da Silva, Brazil
Zulmira Silva, International Center for AIDS Care and Treatment Programs (ICAP), Mozambique
Rajesh Singh, International Unnion Against Tuberculosis and Lung Diseases, India
Wallen Sinkala, Second Life Support Group, Zambia
Natalie Skipper, Community Research Advisory Group (CRAG), USA
Alisha Smith-Arthur, University Research Co., LLC (URC),
Jussara Soares, Brazil
Rinn Song, Harvard Medical School, USA
Izabel S. de Souza Souza, Brazil
Jurema Souza, Universidade Federal do Rio de Janeiro, Brazil
Joel Spicer, Stop TB Partnership (STBP), Switzerland
Jeff Starke, Texas Children's Hospital, USA
Jonathan Stillo, The City University of New York, USA
Lucia Maria Stirbu, European AIDS Treatment Group (EATG), Romania
Jayasankar Subramoniapillai, Revised National TB Control Program (RNTCP), India
Khairunisa Suleiman, Kenya/South Africa
Dan Sullivan, Bill Sullivan-Ray of Hope Foundation, USA
Honghu Sun, Sichuan University, China
Soumya Swaminathan, National Institute for Research in Tuberculosis, India, India
Bekana Kebede Tadese, University of Gondar, Ethiopia
Sabira Tahseen, National TB reference laboratory Pakistan, Pakistan
Alla Tannil, Estonian Network of People Living with HIV (EHPV), Estonia
Ivanir Tavares, Brazil
Ezio Tavora Santos-Filho, Rede TB, Brazil
Anna Tkacheva, Belarus
Anete Trajman, Brazil
Liudmila Trukhan, Positive Movement, Belarus
Thet Tin Tun, Burnet Institute Myanmar, Myanmar
Mary grace Tungdim, Department of Anthropology, University of Delhi, Delhi-110007, India
Nicole Turcotte, Gay Men's Health Crisis (GMHC), USA
Nonna Turusbekova, TBC Consult/HRM for Health, Netherlands
Ibrahim Umoru, Good Health Educators Initiative, Nigeria
Daniel Urrieta Salazar, Instituto Nacional De Salud, Peru
Gulnoz Uzakova, Global Fund to Fight AIDS, TB and Malaria, Uzbekistan
Emmy van der Grinten, KNCV Tuberculosis Foundation, South Africa
Wim Vandevelde, European AIDS Treatment Group (EATG), Europe
Ivan Varentsov, Eurasian Harm Reduction Network, Russia
Emanoil Vasiliu, Baylor International Pediatric AIDS Initiative (BIPAI), Romania
Vladislava Vassitškina, Estonia
VitÛria Vellozo, Secretaria Municipal de Sa˙de e Defesa Civil do Rio de Janeiro, Brazil
Maria Elisa Verdú Jordá, Hospital Carmelo PNCTL, Mozambique
Eliane Vianna, Fundação Oswaldo Cruz (FIOCRUZ), Brazil
Treland Victoria, RESULTS Educational Fund, USA
Sofia Viegas, Instituto Nacional de Sáude, Mozambique
Asha Vijayan, Revised National TB Control Program (RNTCP), India
Shibu Vijayan, Global Health Advocates India, India
Michael Vjecha, USA
Fanny Voitzwinkler, Belgium
Stephen Volante, USA
Vlad Volchkov, International HIV/AIDS Alliance, Ukraine
Balasangameshwara Vollepore, FIND, India
Cornelia Wakhanu,
Ibarakumo Brandon Walson, National Emergency Management Agency (South - South Zone), Nigeria
Eliud Wandwalo, Management Sciences for Health, Tanzania
Genevieve Warner Learmonth, University of Cape Town and Groote Schuur Hospital Cytopathology Laboratory, South Africa
Diana Weil, USA
Mariana Weinberger, Israel
Abimbola Esther Wintolu, PLAN Health Advocacy and Development Foundation, Nigeria
Abdullahi Yakubu Gida, TBL Control Programme, Bauchi, Nigeria
Mohammed Yassin, Global Fund to Fight AIDS, Tuberculosis and Malaria, Switzerland
Joannes Paulus Yimbesalu, Cameroon
Thamer Yousif Al Hilfi, Iraqi Anti Tuberculosis Association, Iraq
Nadiia Zaiets, Estonian Network of People Living with HIV (EHPV), Estonia
Carlos Zamudio, Universidad Peruana Cayetano Heredia, Peru
Khin Zaw, Save the Children Myanmar, Myanmar
Ирина Агеева, Всеукраинская Сеть людей с ВИЧ, Украина
Кирилл Арсёнов, КО ВБО "Всеукраинская Сеть ЛЖВ", Украина
Чынара Бакирова, ОЮЛ "Ассоциация СПИД-сервисных НПО Кыргызской Республики ""АнтиСПИД"", Кыргызстан
Чынара Бакирова, ОЮЛ "Ассоциация СПИД-сервисных НПО Кыргызской Республики ""АнтиСПИД"", Кыргызстан
Юрий Боровой, The Association of Substitution Treatment Advocates of Ukraine (ASTAU), Ukraine
Ирина Галаченко, Молдова
андрей гуппал, эстония
Natalia Мardari, Credinta, Moldova
Игорь Морозов, клуб " свитанок, Украина
Анастасия Полякова, Россия
Ольга Пономарёва, клуб " свитанок, Украина
Ксения Проданова, КРУ"Центр профилактики и борьбы со СПИДом", Украина
Андрей Скворцов, The International Coalition Treatment Preparedness (ITPCru), Россия
Дмитрий Чехов, Украина
Оксана Ярош, ХОБФ"Парус", Украина