Feature Story

Jorge Sampaio, UN Secretary General's
Special Envoy to Stop TB

Ahead of World TB Day, UNAIDS asks the UN Secretary General’s Special Envoy to Stop TB and former President of Portugal, Dr Jorge Sampaio about his involvement in the fight against TB, its links with HIV and what he sees are the top priorities for HIV/TB collaboration in the future.

1. During the last decade, you have made important contributions to many of the challenges currently facing the international community. What made you passionate about becoming more involved in TB?

For me, health for all is a matter of human rights. Three out of the eight Millennium Development Goals are health-related and include fighting against the three global pandemics, AIDS, tuberculosis and malaria. I’ve been aware of TB all my life because my father was a doctor––but I realized that TB was a major new public health emergency when the MDGs started being discussed around the turn of this century.

2. How do you think your role in politics is helping you to fulfil your new role as Special Envoy to Stop TB?

I am a lawyer by profession and obviously that helps with advocacy, I have also had a long political career (now I am retired!), so I am used to political negotiations and have had a lot of experience in diplomatic and international affairs. In my personal view, political experience is critical because my role as a Special Envoy is not to settle technical questions, but rather to increase political and social support for the TB control policies recommended by WHO and the Stop TB Partnership. My main focus is to persuade world leaders, policy makers, main international, regional and national stakeholders, the media, the private sector, patients, communities and others to secure greater political support for fully funding and implementing the Global Plan to Stop TB.

3. What role do you think the HIV community and UNAIDS can play in implementing the Global Plan to Stop TB?

Jorge Sampaio Met with UNAIDS
Executive Director, Dr Peter Piot
in Geneva earlier this year to
move the agenda forward on TB
control including the HIV/TB co-
epidemic and XDR-TB

One of the main points I always emphasize is the need to stimulate a co ordinated approach to HIV and TB. Together HIV and TB generate a noxious synergy that accelerates each other’s progression and has led to an explosion of TB cases in regions with high HIV prevalence. In order to control TB in high HIV prevalence settings far more effective collaboration between TB and HIV programmes and communities must be implemented.

I do think that the Global Plan to Stop TB and TB programs based on the WHO Stop TB strategy, as well as UNAIDS’ plans for universal access to HIV prevention, treatment, care and support represent an appropriate framework to scale up TB/HIV collaborative efforts. But some gaps remain––particularly in the areas of political and resource commitment to collaborative TB/HIV activities and new tools for prevention, early diagnosis and rapid treatment of TB in people living with HIV.

4. How can we encourage the TB and HIV communities to work more closely together?

Education for health is dramatically needed to counteract stigma and social discrimination surrounding HIV and TB. Communities have to know the basic facts; TB causes at least 11% of total deaths in people living with HIV (this can rise to as much as 60% in some African settings); 750,000 people living with HIV develop TB each year; most TB can be successfully treated even in people living with HIV; untreated, TB will cause death within weeks for people living with HIV; t reatment of TB can prolong and improve the quality of life for HIV-positive people.

5. How do you think we can keep the world interested in TB and HIV, despite competing issues such as global warming, avian flu, terrorism? 

Health is a key dimension of human safety and development, and is a matter of human rights. To realize these very basic rights worldwide, we need to double efforts and avoid working at cross-purposes which delays us unnecessarily.

6. If we are to have a real chance of getting ahead of these epidemics what, in your opinion, are the areas that the world should be focusing on?

UN Secretary-General Ban Ki-moon with
Jorge Sampaio at UN Headquarters in
New York

In my own personal view, four overarching but long overdue issues deserve immediate attention and call for strong extra action by the international community.

First, keeping the fight against TB high on the global agenda, particularly in light of the emerging of multidrug-resistant and extensively drug-resistant TB, which poses a new major public health threat and requires urgent action.

Secondly, improving coordination in the fight against AIDS and TB.

Third, Africa . Africa must be top priority and put at the highest spot on the international agenda––it is not acceptable that it should remain a continent at risk. Sub-Saharan Africa faces the greatest health challenges, with 11% of the world’s population and 24% of the global burden of TB disease, yet only 3% of the world’s health workers.

Fourth, s trengthening health systems––promoting a global plan to strengthen health systems is a key issue in achieving most of the health related MDGs.