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Thursday Thought: The importance of Evidence Informed Decision Making | Dr Kerry Millington


For this Thursday Thought, we're delighted to welcome a guest author to the page. Dr Kerry Millington is Co-Chair of UK Academics & Professionals to End TB , and a Research Uptake Manager at the Liverpool School of Tropical Medicine for the LIGHT research programme consortium. Today, she's sharing some reflections about the importance of Evidence Informed Decision Making following last week's UN High Level Meetings.


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“Advancing science” was at the forefront of the theme of the second United Nations High-Level Meeting on the Fight Against Tuberculosis (TB) held last Friday 22 September 2023 in New York. The political declaration adopted by Member States committed to “maximise the potential of innovation to end TB” and “the right to enjoy and share the benefits of scientific progress”. The Global Sustainable Development Report 2023 released early this month also highlights the vital role of science-based policies in achieving the Sustainable Development Goals. So how do we get there?


Although COVID-19 significantly impacted, albeit slow, progress in ending TB, the speed with which new tools were developed, approved, and rolled out provides a precedent of what coordinated, collective action can achieve in addressing a global infectious disease with science at the core. We must also learn from the failings of the response to COVID-19 by ensuring the response to TB is person-centred and equitable.


Scientific progress towards ending TB is advancing, especially since the UN High-Level Meeting in 2018, but we must and can do better. We still need simple point of care tests that diagnose in the community, short enough drug regimens that are acceptable and do not cause horrendous side effects, and we do not yet have delivery of an effective vaccine that not only protects young children from severe forms of TB but which also protects adolescents and adults, where most TB transmission occurs. We must also address the social and economic determinants of the disease ensuring that we have the systems across sectors in place to deliver to those most in need. This includes strengthening inclusive, integrated, and resilient quality health systems.


We know that the new tools that are available are not reaching people affected by TB as fast or as universally as they should be. By aligning across the health agendas discussed last week at the United Nations General Assembly High-Level Meetings on TB, advancing Universal Health Coverage and preventing, preparing and responding to pandemic threats, we will be one step closer to leaving no-one behind.


Increased financing for TB research and innovation is a big part of what we need to move forward, with only half of the 2 billion US dollars a year target that was agreed in 2018 political declaration having being met. Member States have again committed to increased, sustained, and equitable financing in TB research and development. The global TB community urge for this funding commitment to this time be met, along with swifter, more collaborative, evidence-informed policy decisions that are implemented.


As the work now starts translating the global commitments and targets to the national level, let us ensure that academics and health professionals from across disciplines and specialties, along with other experts including affected communities, are meaningfully engaged as credible and trusted stakeholders. Only by working together can we co-create research to ensure the right questions are being asked and provide robust evidence to inform effective policy pathways, smart investment, and stronger accountability. COVID-19 showed us what we can achieve when working in partnership in a coordinated and collective way, so let us all play our role in delivering the right of our communities to enjoy and share the benefits of scientific progress for a tuberculosis-free world.


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