TB advocacy: new government, new approach

After months of campaigning and days of wrangling behind the scenes, Britain finally has a new coalition government of Conservative and Liberal Democrat Ministers. So what will the new government mean for the UK’s approach to international development and how can those fighting to eradicate TB around the world get strong commitments on TB issues from the coalition government?

Given that the times of fiscal austerity are well and truly upon us, it is reassuring that the commitment from both Liberal Democrats and the Conservatives to spending 0.7% of GNI on overseas aid is laid down in the coalition agreement between the two parties. Beyond this agreement on overall funding, it is likely that Conservative Party thinking on international development will dominate policy in the new government – all three ministers in the Department for International Development are from the Conservative Party.

We can hopefully get a good idea of what the government plans for international development (and more specifically TB) by looking at their 2009 policy paper, ‘One World Conservatism’. This paper includes a strong emphasis on aid effectiveness, value for money and transparency. It highlights the ways that international development works in the UK’s national interest, and specifically mentions combating drug-resistant diseases in this context. It also emphasises the need to put in place the ‘building blocks of development’, creating conditions to allow domestic enterprise to drive development.

Campaigners need to demonstrate how eradicating TB ties-in with the ethos and aims of Conservative international development thinking to ensure the new government puts combating TB at the top of their agenda. So the case should be made clearly that spending money on fighting TB is cost effective – in Africa, the economic benefits of the WHO’s TB strategy could exceed costs by 9 times. It will also mean promoting TB programmes which are transparent and are targeted at the very poorest where other domestic sources of funding are not available.

To make sure overseas aid is spent where it is most needed, the Conservatives have promised to review which countries UK tax payers’ money is spent in. For example, China is on the list of countries which the Conservative Party has previously said is rich enough to no longer receive UK development spending. Could programmes in India, which is rapidly developing, set to host the Commonwealth Games this year, and spending money on its space programme lose funding too? Campaigners will need to make robust, hard-headed arguments to government ministers if they want to see UK development aid continue to be spent on TB programmes in countries with rapidly expanding economies.

To demonstrate how fighting TB is clearly in Britain’s interests, campaigners should also emphasise the links between TB abroad and rates of the disease in the UK. TB still kills hundreds of people in Britain each year and cases are rising. Advocates should stress that in an increasingly globalised world it is entirely in the UK’s national interest to ensure that we invest now towards the achievable objective of controlling TB, especially before drug resistant TB becomes increasingly prevalent. This argument could be extended to encouraging investment in new drugs and diagnostics, particularly if DFID funding for this is directed towards UK companies and research institutions.

Another argument likely to be well received by the new executive is that TB is a barrier to the poorest people in the world being able to work their way out of poverty. This means emphasising the education children lose from being sick with TB or caring for family members; emphasising that TB affects people of working age during the most productive stages of their life; and emphasising that TB kills more women than all causes of maternal mortality combined. But we should also argue that on a wider level too, high rates of TB burden the economies of the poorest countries. Without treatment the cost of TB-related deaths in sub-Saharan Africa from 2006-2015 could be over $500 billion.

This list is by no means definitive, but it provides some ideas about how anti-TB campaigners should seek to engage with the new government. While Treasury purse strings remain tight, TB campaigners need to make sure that tackling this disease is entrenched in the way the new government fights international poverty. Showing how eradicating TB resonates with the ideas in ‘One World Conservatism’ will be an important part of this.

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