Editorial
David Parker/Science Photo Library/Corbis
A new brand for tuberculosis
See Comment page 1016
For the Global Tuberculosis Report 2013 see http://apps. who.int/iris/bitstream/ 10665/91355/1/ 9789241564656_eng.pdf For more on grand convergence see Lancet 2014; 383: 187
The Lancet received an interesting email last week— an invitation to participate in the research stage of a new Stop TB Partnership initiative to build a brand for tuberculosis from Siegel+Gale, a London-based branding agency who have been commissioned to undertake the work. The aim of the project is to develop an iconic and lasting identity for tuberculosis. The goal is to create a brand that will raise the profile of the disease, influence high-level decision makers, attract necessary resources, and amplify the voice of the tuberculosis community. Is such an initiative needed? Tuberculosis mortality has fallen by more than 45% since 1990, and incidence is declining, but the global burden and challenges remain substantial. In 2012, there were an estimated 8·6 million new cases of tuberculosis worldwide and 1·3 million people died from the disease. Every year, an estimated 3 million people with active tuberculosis are either not diagnosed or are diagnosed but not reported, and continue to spread the disease, with many dying from it. In 2012, around 16 000 patients with multidrug-resistant tuberculosis
reported to WHO were not put on treatment. Care for tuberculosis patients living with HIV is also substandard; many do not receive prompt antiretroviral therapy. In a Comment in today’s Lancet, ahead of World TB Day on March 24, Alimuddin Zumla and colleagues note two essential requirements for rapid progress: commitment at the highest political level and the necessary resources. Raising the profile of tuberculosis will be key to achieving these goals. Indeed, the tuberculosis community has felt neglected internationally when compared with HIV/AIDS and other global health priorities that have received recent high-level attention such as maternal and child health. But is developing a new brand solely for tuberculosis the right way forward? Such an initiative continues the battle between diseases that has long been the status quo in global health. Championing the idea of grand convergence—a reduction in preventable infectious diseases (including tuberculosis), and maternal and child deaths to universally low levels—could be more compelling as we enter a post-2015 world. The Lancet
Unicef Middle East & North Africa 2014
Syria: 3 years of suffering
For the UNICEF report see http://www.unicefusa.org/ assets/pdf/UN01137.pdf For the Save the Children report see http://www.savethechildren. org.uk/resources/online-library/ devastating-toll See Correspondence Lancet 2013; 381: 1179 and Lancet 2014; 383: 303
1014
This week the conflict in Syria reaches another grim milestone. An uprising in the small city of Daraa 3 years ago has now developed into a complex war with regional and international ramifications. Between a regime fighting for its survival and disparate opposition forces, the Syrian population is caught in a vice— besieged or displaced—placing an unprecedented burden on neighbouring host countries Lebanon, Jordan, Turkey, Iraq, and Egypt. While the conflict shows no end in sight, two reports released this week describe the intolerable effect Syria’s 3 year war has had on children. UNICEF’s report Under Siege—the devastating impact on children of three years of conflict in Syria stresses that 5·5 million Syrian children are now affected by the conflict inside and outside Syria. 1·2 million are refugees. 1 million live under siege or in areas difficult to reach with humanitarian assistance because of continued violence. Many children are left without protection, or medical or psychological support, with little or no access to education. UNICEF warns of a lost generation: a generation of children shaped by
violence and displacement with developmental and emotional scars, which will have profound long-term consequences for Syria and beyond. Adding to this grim picture, Save the Children’s report A Devastating Toll: the impact of three years of war on the health of Syria’s children examines Syria’s ravaged health system and what this means for children and their mothers. Echoing letters in The Lancet from Syrian doctors, the report outlines the lack of medical staff and access to adequate care, equipment, and medicine. Vaccine-preventable infectious diseases such as measles and polio have reappeared. Women face huge difficulties in accessing antenatal, delivery, and postnatal care— children’s lives are threatened before they are even born. 3 years is a lifetime for most children. “Must they endure another year of suffering?” asks UNICEF Executive Director Anthony Lake. While intensified efforts are needed to find a solution to the crisis, there is a growing sense that the international community is turning away from one of the worst humanitarian disasters. We must not forget Syria. The Lancet www.thelancet.com Vol 383 March 22, 2014
David Parker/Science Photo Library/Corbis
A new brand for tuberculosis
See Comment page 1016
For the Global Tuberculosis Report 2013 see http://apps. who.int/iris/bitstream/ 10665/91355/1/ 9789241564656_eng.pdf For more on grand convergence see Lancet 2014; 383: 187
The Lancet received an interesting email last week— an invitation to participate in the research stage of a new Stop TB Partnership initiative to build a brand for tuberculosis from Siegel+Gale, a London-based branding agency who have been commissioned to undertake the work. The aim of the project is to develop an iconic and lasting identity for tuberculosis. The goal is to create a brand that will raise the profile of the disease, influence high-level decision makers, attract necessary resources, and amplify the voice of the tuberculosis community. Is such an initiative needed? Tuberculosis mortality has fallen by more than 45% since 1990, and incidence is declining, but the global burden and challenges remain substantial. In 2012, there were an estimated 8·6 million new cases of tuberculosis worldwide and 1·3 million people died from the disease. Every year, an estimated 3 million people with active tuberculosis are either not diagnosed or are diagnosed but not reported, and continue to spread the disease, with many dying from it. In 2012, around 16 000 patients with multidrug-resistant tuberculosis
reported to WHO were not put on treatment. Care for tuberculosis patients living with HIV is also substandard; many do not receive prompt antiretroviral therapy. In a Comment in today’s Lancet, ahead of World TB Day on March 24, Alimuddin Zumla and colleagues note two essential requirements for rapid progress: commitment at the highest political level and the necessary resources. Raising the profile of tuberculosis will be key to achieving these goals. Indeed, the tuberculosis community has felt neglected internationally when compared with HIV/AIDS and other global health priorities that have received recent high-level attention such as maternal and child health. But is developing a new brand solely for tuberculosis the right way forward? Such an initiative continues the battle between diseases that has long been the status quo in global health. Championing the idea of grand convergence—a reduction in preventable infectious diseases (including tuberculosis), and maternal and child deaths to universally low levels—could be more compelling as we enter a post-2015 world. The Lancet
Unicef Middle East & North Africa 2014
Syria: 3 years of suffering
For the UNICEF report see http://www.unicefusa.org/ assets/pdf/UN01137.pdf For the Save the Children report see http://www.savethechildren. org.uk/resources/online-library/ devastating-toll See Correspondence Lancet 2013; 381: 1179 and Lancet 2014; 383: 303
1014
This week the conflict in Syria reaches another grim milestone. An uprising in the small city of Daraa 3 years ago has now developed into a complex war with regional and international ramifications. Between a regime fighting for its survival and disparate opposition forces, the Syrian population is caught in a vice— besieged or displaced—placing an unprecedented burden on neighbouring host countries Lebanon, Jordan, Turkey, Iraq, and Egypt. While the conflict shows no end in sight, two reports released this week describe the intolerable effect Syria’s 3 year war has had on children. UNICEF’s report Under Siege—the devastating impact on children of three years of conflict in Syria stresses that 5·5 million Syrian children are now affected by the conflict inside and outside Syria. 1·2 million are refugees. 1 million live under siege or in areas difficult to reach with humanitarian assistance because of continued violence. Many children are left without protection, or medical or psychological support, with little or no access to education. UNICEF warns of a lost generation: a generation of children shaped by
violence and displacement with developmental and emotional scars, which will have profound long-term consequences for Syria and beyond. Adding to this grim picture, Save the Children’s report A Devastating Toll: the impact of three years of war on the health of Syria’s children examines Syria’s ravaged health system and what this means for children and their mothers. Echoing letters in The Lancet from Syrian doctors, the report outlines the lack of medical staff and access to adequate care, equipment, and medicine. Vaccine-preventable infectious diseases such as measles and polio have reappeared. Women face huge difficulties in accessing antenatal, delivery, and postnatal care— children’s lives are threatened before they are even born. 3 years is a lifetime for most children. “Must they endure another year of suffering?” asks UNICEF Executive Director Anthony Lake. While intensified efforts are needed to find a solution to the crisis, there is a growing sense that the international community is turning away from one of the worst humanitarian disasters. We must not forget Syria. The Lancet www.thelancet.com Vol 383 March 22, 2014
