Black and white photos of gaunt tuberculosis victims breathing their last breaths, while comforted by volunteers and family members who wash their skeletal bodies or hold their hands as they lay dying, are on display at the United Nations Headquarters in New York to mark World TB Day, 24 March. The people in the photos should be healthy, productive adults, but are instead reduced to shrunken bags of skin and bones, ravaged by a curable disease that killed 1.6 million in 2005, according to the World Health Organization (WHO).

A top UN envoy joined health experts, a messenger of peace and a world-renowned photographer in an effort to raise awareness about Tuberculosis at UN Headquarters on 22 March 2007. In addition to launching a report by the WHO, officials also commemorated World TB Day with the opening of a photo exhibit and meeting with non-governmental organizations (NGOs) on 22 March 2007.

Photo: James Nachtwey

"There is much to be done to put TB on the global agenda", said Jorge Sampaio, the UN Secretary-General's Special Envoy to Stop Tuberculosis at the launch of the Global Tuberculosis Control Report by the WHO. The report shows that while the percentage of the world's population affected by TB has leveled off in recent years, progress is threatened by the spread of HIV and new strains of TB that are resistant to drugs, as well as lack of adequate funding for treatment.

He said that while HIV/AIDS was a highly visible disease, the connection between that pandemic and TB was often not being made. TB is a leading killer of people with HIV/AIDS, most of these in Sub-Saharan Africa, according to the WHO. Mr. Sampaio, a former President of Portugal, also called for "new attention to Africa", and the strengthening of networks to deliver drugs to treat TB.

"The global incidence of TB may have peaked in 2005", said Dr. Mario Raviglione, WHO's director of the Stop TB Department, expressing optimism that Millennium Development Goal (MDG) number 6, aimed at stopping and reversing the spread of the disease, may be achieved before its target date of 2015.

However, he warned that "elimination of tuberculosis, which is the ultimate target for 2050, may in fact not be reached for centuries". He also cited "scary situations of new strains that are extremely resistant" to powerful first and second-line drugs, which have been reported 35 countries and occurred at especially high rates in the former Soviet Union and China.

The WHO report also showed that the total number of new TB cases continues to rise, albeit at a lower rate than the world's population growth.

"To cure tuberculosis, you must take medicine every day for six months to be completely cured of TB, at a total cost of $20", said Anna Cataldi, Italian author and journalist and a UN Messenger of Peace. "Why can people not get access these medicines? It is so inexpensive. This is a question of distribution." She also pointed out that the daily deaths from TB, around 4,400, were the equivalent of 15 planes, each with 300 people on board, crashing everyday, with no survivors.

In a meeting with NGO representatives, Mr. Sampaio spoke of the extreme importance of the work of a "magic network of volunteers doing concrete activities" to combat the spread of TB. He said the NGOs were absolutely essential in the struggle, and that they had an "irreplaceable role" in delivering healthcare to those who most need it.

"The WHO sits in Geneva or in country capitols, next to health ministries", said Mr. Raviglione, explaining that NGOs are able to deliver healthcare and education to remote areas of countries heavily burdened by TB. NGOs are also able to mobilize public opinion and create political pressure for action on TB, he said.

Because TB had practically disappeared in developed countries, the disease had fallen out of global consciousness by the 1970s and 1980s, said Mr. Raviglione. "It was not that TB was gone, it had declined in the North, but not in the developing world", said Mr. Raviglione. He said that in 1989, there were only two people at the World Health Organization dedicated to TB, compared to 90 people today.

"Because of de-funding after the 1960's, TB went up a lot", said Dr. Lee B. Reichman, a TB expert. He said that because national coalitions of NGOs and government TB experts "raised hell", funding increased dramatically, and today "TB people are a force to be reckoned with".

"But what are governments interested in now, what do they want to spend money on? The Avian Flu!" said Mr. Reichman, pointing out that 30 times the number of people that died from that disease, 166, die from TB every day.

"I felt it was important to show how much people were suffering from TB, but also that they are not suffering in total isolation", said internationally acclaimed photographer James Nachtwey, whose haunting photos of skeletal victims of TB are on display at UN Headquarters. "We cannot forget the contributions of the many international and local NGOs and family members who are there to comfort victims of TB."

Speaking at the opening of the photo exhibit, UN Deputy Secretary-General Asha-Rose Migiro said "my own homeland is heavily affected by TB and I have seen the devastating effects of this disease first hand. Although drugs to treat TB are relatively inexpensive, they remain out of the reach of poor people." She pointed out that 2 billion people, or one-third of the world's population, are infected with the TB Bacilli, and, according to the WHO, one in ten of these people will become sick with TB.

In his message for World TB Day, UN Secretary-General Ban Ki-moon called for the implementation of the WHO's Global Plan to Stop TB, 2006-2015, saying that 14 million lives could be saved. "A cost-effective cure for TB has been available for more than 50 years. Yet for many, life-saving treatments still remain out of reach. We need more political will. We need better financing. Let this be the year to scale up action against all forms of TB anywhere and everywhere."