Following is the September 26, 2018, statement of Archbishop Paul Richard Gallagher, Vatican Secretary for Relations with States, Head of the Delegation of the Holy See to the Seventy-third Session of the United Nations General Assembly, at the High-level Meeting entitled “United to end tuberculosis: an urgent global response to a global epidemic”.
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Madam President,
The Holy See is pleased to participate in this first-ever High-level Meeting on the fight against tuberculosis.
The theme, “United to end tuberculosis: an urgent global response to a global epidemic,” spells out the three most important elements of this High-level Meeting, namely, the gravity of the problem, the urgency of addressing it, and the unity needed to fight it effectively.
The good news is that tuberculosis is preventable and curable. The bad news is that it is still so prevalent that it remains a global health emergency. Tuberculosis has long accompanied humanity’s journey, but progress in prevention and treatment in recent times have led many in the developed world to believe that this infectious pathology was a thing of the past. The reality, however, is that one-quarter of the world’s population is still infected with the bacteria that causes the disease, and various strands are now multi-drug resistant. Tuberculosis continues, therefore, to take a very heavy toll on victims, their families, and the global health system.
Madam President,
Tuberculosis remains, for obvious reasons, strongly associated with poverty and disproportionately affects developing countries, where 99 percent of TB-associated deaths occur. Strategies to end tuberculosis must, therefore, be targeted to the poorest populations that are most at risk and should address the most significant determinants of this disease, such as poor nutrition, unhealthy living conditions and lack of basic health care. An effective global response must necessarily include access to affordable diagnostic tests and treatment, especially in countries where the disease is most prevalent. This means that the goal of ending the tuberculosis epidemic by 2030 must be framed within the bigger fight against poverty and social inequalities.
In certain places and cultures, people afflicted by tuberculosis are segregated and suffer humiliating stigmatization. The global response must, therefore, include practical interventions that encourage closeness to those who are sick, inspired by true compassion and solidarity. Indeed, closeness to those afflicted with tuberculosis should be considered an important benchmark in any effective response to tuberculosis. The example of so many caregivers, especially female and elderly family members, shows how proximity to the sick restores their human dignity and sense of worth. A global response to tuberculosis would be more effective and person-centered if it integrated family-based policies and services. The family is in the best position to respond to various vulnerabilities faced by the patient, especially when those affected are children, the elderly and women.
Moreover, closeness to the sick transforms mentalities and prejudices against persons suffering with tuberculosis. Teaching by example is the best way to combat socio-cultural barriers that cause the isolation and stigmatization of TB sufferers and to change social perceptions that allow others to turn their backs on them. Pope Francis invites us not just to see but to look; not just to hear but to listen; not just to pass people by but to stop; not just to say “what a shame, poor people!,” but to allow ourselves to be moved with compassion; “and then to draw near, to touch and to say: ‘Do not weep’ and to give at least a drop of life”.[1]
The Holy See wishes to underline the decisive role that research plays in any effective global response to tuberculosis. Collaboration between public and private sectors must be encouraged to finance continued pharmaceutical research for more effective and affordable treatment, and to find new medicines to fight multidrug-resistant tuberculosis, which is estimated to account for one-third of deaths due to antimicrobial resistance. Given the heavy additional burden that multidrug-resistant tuberculosis and TB mortality place on the health systems of poor and developing countries, a global sharing of the science and technology of TB treatment could help prevent those countries from sliding further into underdevelopment and poverty.
In this regard, my Delegation would like to echo those concerns expressed by groups engaged in projects of development and health care – including faith-based organizations that serve the poor and those most excluded – with regard to agreements on intellectual property and access to medicines and essential health care. Regional free trade treaties dealing with the protection of intellectual property, particularly in pharmaceuticals and biotechnology, should not simply seek to protect the powers granted to States by multilateral agreements, but should also ensure access to basic health care and treatment for all. Interdependence and the integration of economies should not be achieved at the cost of weakening existing systems of health care and social security; instead, they should promote their creation and good functioning.
Madam President,
It is my Delegation’s hope that the deliberations of this High-level Meeting will not simply balance conflicting interests but genuinely serve those in greatest need. The urgency of a global response to this global epidemic means that we must never stop seeking the most effective and affordable cure for tuberculosis and the best way to assist those affected by it, together with their families and communities.
Thank you, Madam President.
1. Pope Francis, Morning meditation in the Chapel of the Domus Sanctae Marthae, 13 September 2016.
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