P 250428Z FEB 09
FM SECSTATE WASHDC
TO ALL DIPLOMATIC AND CONSULAR POSTS COLLECTIVE PRIORITY
AMEMBASSY TRIPOLI PRIORITY

UNCLAS STATE 017303 
 
 
E.O. 12958: N/A 
TAGS: TBIO SOCI PREL KPAO
SUBJECT: HIGHLIGHTING WORLD TB DAY - MARCH 24, 2009 
 
REFTEL: STATE 4510 
 
 
¶1.  (U) This is an action request.  Please see 
paragraphs 3-4. 
 
¶2.  (U) World TB Day is March 24. This annual event 
commemorates the date in 1882 when Dr. Robert Koch 
announced his discovery of the bacteria that causes 
tuberculosis (TB).  The World Health Organization 
(WHO), the United States, and countries around the 
world will commemorate this day by celebrating the 
lives and stories of people affected by TB: women, men 
and children who have taken TB treatment, medical 
professionals, researchers, and community workers ? all 
essential team members in the global fight against TB. 
 
¶3.  (U) ACTION REQUEST:  World TB Day is an opportunity 
for Chiefs of Mission, USAID Mission Directors, Public 
Affairs Officers, ESTH Officers, HHS Attaches, CDC 
Chiefs of Party, and Medical Officers to highlight the 
USG commitment to prevent and control the spread of 
this major global public health problem and underscore 
host governments' efforts to do the same.  Department 
requests that where possible Posts, in coordination 
with USG agencies involved in TB activities in country, 
such as USAID, conduct appropriate outreach and public 
diplomacy events.  Posts should feel free, where 
appropriate, to invite local media to attend these 
events and to provide press releases and op-eds to 
local media outlets (END ACTION REQUEST). 
 
Suggestions include: 
 
-  Host an outreach or awareness event.  For example, 
Posts can host a joint press event with the local 
community leaders and other partners on TB. 
 
- Organize a health project site visit.  Chiefs of 
Mission, USAID Mission Directors, or other Mission 
officials could visit TB clinics and meet with patients 
and health professionals. 
 
- Host a roundtable discussion.  For example, Posts can 
create a health worker roundtable event to foster 
discussions about the local efforts to fight TB. 
 
- Report on special groups or populations. Working with 
the appropriate Mission officials, officers can report 
on TB within special populations in the country, such 
as the military, youth, elderly or at-risk groups. 
 
- Organize interviews with local press.  In this 
scenario, Posts would arrange interviews with local 
media outlets to discuss World TB Day and the USG 
contribution to combating the disease. 
 
- Engage local youth.  Posts could organize artistic, 
lyrical, or other competitions for children in which 
they present ways to reduce stigma towards persons 
living with TB and to protect against infection. 
 
¶4.  (U) Department would appreciate reports from Posts 
regarding TB Day activities via e-mail or front channel 
cable.  Please slug responses to Jehan Jones, OES/IHB 
(JonesJS2@state.gov). 
 
¶5.  (U) In preparing for World TB Day events, Posts may 
wish to draw upon the following building blocks. 
 
¶6.  (U) Building Blocks: 
 
- Despite recent progress, tuberculosis (TB) remains a 
major global public health problem, with nearly nine 
million new cases and more than 1.7 million deaths each 
year.  With HIV/AIDS claiming over two million lives 
each year, and malaria killing more than one million, 
TB is one of the three leading causes of deaths 
worldwide due to an infectious disease. 
 
- TB strikes people during their most economically 
productive years.  TB not only takes an enormous 
personal toll, it also places a tremendous economic 
burden on families, communities, and countries.  While 
TB treatment is often free, diagnosis, laboratory 
charges, transport, food and other costs can account 
for up to 20 percent of annual household income for TB 
patients, according to the World Bank. 
 
- Although a cure for TB has existed for more than half 
a century, the disease is often diagnosed late, treated 
improperly, or not treated at all, leading to 
transmission in the community and death. 
Unfortunately, the most vulnerable people have the 
greatest difficulties in accessing good quality care. 
TB is both a disease of poverty - with transmission 
enhanced in over-crowded conditions - and a contributor 
to poverty. 
 
- The USG is on the frontlines of the battle against 
TB.  In collaboration with host nation TB programs, the 
USG works to improve the quality of basic TB programs 
or DOTS (Directly Observed Therapy, Short Course) 
services; upgrade laboratory infrastructure; build a 
foundation to introduce new diagnostic technologies; 
and work with WHO and other partners to conduct drug 
resistance surveys and surveillance.  This is an 
opportunity to showcase USG contributions to global 
health and scientific progress. 
 
- On July 30, 2008 the Tom Lantos and Henry Hyde United 
States Global Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Reauthorization Act of 2008 
was signed into law, authorizing up to $48 billion over 
the next five years to combat global HIV/AIDS, 
tuberculosis, and malaria. 
 
- The U.S. Agency for International Development (USAID) 
is the lead USG agency in international TB control 
programs, supporting TB programs in 40 countries, with 
the President's Emergency Plan for AIDS Relief (PEPFAR) 
taking the lead role in TB/HIV co-infection, and the 
U.S.  Department of Health and Human Services, Centers 
for Disease Control and Prevention (HHS/CDC) providing 
critical technical support to global and country level 
initiatives.  The National Institutes of Health (NIH) 
is engaged in basic investigations and international 
clinical research studies related to TB.  Coordination 
and collaboration among these agencies is extensive and 
very effective in both the domestic and global spheres. 
 
- Between 2000 and 2008, USAID provided over 760 
million USD for TB programs worldwide.  In FY 2008, 
USAID provided close to $15 million USD to the STOP TB 
Partnership's Global TB Drug Facility (GDF), an 
important mechanism that provides drugs to countries in 
need.  PEPFAR increased its funding for HIV/TB five- 
fold, from 26 million USD to 140 million USD, from 
fiscal year 2005 to fiscal year 2008.  The USG also 
supports TB control worldwide through funding provided 
to the Global Fund to Fight AIDS, TB and Malaria 
(Global Fund), to which the USG is the largest single 
donor, with contributions given almost 3.3 billion USD, 
or about 27 percent of total contributions.  Seventeen 
percent of support for the Global Fund has been 
dedicated to TB work. 
 
- TB is the leading cause of death for AIDS patients in 
sub-Saharan Africa.  In parts of sub-Saharan Africa, 
rates of co-infection exceed 50 percent.  By the end of 
September 2008, PEPFAR had supported care for more than 
395,400 TB/HIV co-infected people in the 15 PEPFAR 
focus countries, mostly in Africa. 
 
- Specifically with regard to multi-drug resistant 
tuberculosis (MDR TB) and extensively drug resistant 
tuberculosis (XDR TB), the USG is deeply concerned 
about the magnitude of the drug-resistance problem and 
we are committed to preventing its occurrence and 
addressing it.  Our work to assist countries to 
strengthen their basic TB programs helps to prevent the 
development of drug resistance.  The USG has also been 
a global leader in addressing MDR TB.  In the last two 
years, we have moved quickly to help our international 
partners respond to the latest data on MDR and XDR TB. 
This has included support for drug-resistance surveys 
and the building of laboratory capacity to detect 
resistant strains, expanding country level programs to 
treat MDR TB patients, and support for the Green Light 
Committee (GLC), which helps ensure that countries have 
effective programs to manage MDR TB patients and second 
line anti-TB drugs. 
 
-  Global responses to drug-resistant TB, including XDR 
TB, need to be underpinned by efforts to strengthen the 
basic national infrastructure to diagnose and treat 
regular TB. 
 
¶7.  (U) Additional resources include: 
 
Stop TB 2009 Website: 
http://www.stoptb.org/events/world_tb_day/200 9/ 
 
World TB Day Blog: 
http://www.worldtbday.org 
 
USAID: 
http://www.usaid.gov/our_work/global_health/i d/tubercul 
osis/index.html 
 
PEPFAR: 
http://www.pepfar.gov/pepfar/press/81964.htm 
 
CDC: 
 http://www.cdc.gov/tb/ 
 
WHO: 
http://www.who.int/tb/en/index.html 
 
¶8.  (U) For additional information or assistance, 
please contact Carolyn Mohan, USAID/GH/HIDN (202-712- 
1495 or CMohan@usaid.gov) or Jehan Jones, OES/IHB (202- 
647- 3017 or JonesJS2@state.gov).  To receive building 
blocks in MSWord format, contact Ms. Jones via e-mail. 
 
¶9.  (U) Minimize considered. 
 
 
CLINTON