​​Prioritising Mental Health: A Welcome Development in the UN High-Level Meeting on TB

Yves Miel Zuñiga, Senior Officer, United for Global Mental Health, at the UN High-Level Meeting on TB.

“Stigma will continue to drive patients away – a major reason why TB is still killing someone every 22 seconds. We need targeted support on workplace protection, mental health, public awareness and women empowerment.”  -Handaa Rea, TB survivor and author of the book “STIGMATIZED: A Mongolian Girl’s Journey from Stigma & Illness to Empowerment

The annual United Nations High-Level Week gathers world leaders, diplomats, and stakeholders together to tackle pressing global issues. It is heartening to see more emphasis being placed on mental health, particularly in the High-Level Meeting on ‘Fighting against Tuberculosis (TB).’

Poor mental health has a bidirectional relationship with TB. Depression-related immunosuppression increases the risk of developing active TB, which complicates the disease course and treatment. Living with TB is also a significant risk factor for a decline in an individual’s mental health and for developing a mental health condition.

Aside from the risk of mental illness in people already living with tuberculosis, people who have lived experience of mental health conditions are three times more likely to be subsequently  infected with tuberculosis. This lends credence to the idea that TB and mental health share a bidirectional relationship. Thus, mental health support for TB-affected communities can speed up reduction in TB-related cases and deaths. 

Estimates from United for Global Mental Health’s Bending the Curve report suggest that integrating mental health into TB prevention and treatment could hasten the decline in new TB infections by 12.6 to 20 percent. What this means is that by 2030, over 14 million people around the world could avoid contracting TB.

We commend the following statements on mental health reflected in the approved version of Political Declaration as presented by the President of the UN General Assembly:

• Recognition of Member States that everyone, including TB-affected communities, has the right to the enjoyment of the highest attainable standard of physical and mental health; 
• Emphasis on the multidirectional relationship between tuberculosis, mental health conditions, social and economic determinants, including stigma and discrimination, that can lead to greater morbidity and poorer treatment outcomes, that the prevalence of depression is as high as 45 percent amongst individuals with tuberculosis, and that this needs to be addressed through integrated programming; 
• Commitment of Member States in promoting and protecting the rights to the highest attainable standard of physical and mental health for persons living with TB;  
• Integration of mental health into the basic and comprehensive community-based health services for people living with TB 

Mental health’s inclusion in the approved Political Declaration for the HLM on TB is indeed a welcome development and as a result of collective effort from across different sectors – it represents a growing realisation that mental health is a key component of human health and well-being, rather than a secondary concern to physical health. It is a reaffirmation that mental health should be treated as just as important as physical health, because everyone has the right to the highest attainable level of physical and mental health. 

We thank the Stop TB Partnership (STOP TB), the Global Fund Advocates Network (GFAN) and the wider civil society community for their leadership and inclusive advocacy to ensure that the adopted political declaration is reflective of the aspirations and needs of persons living with TB and TB-affected communities.

As world leaders gather to confront the most pressing concerns of our time, the need to care for the mental health of individuals and TB-affected communities globally has become more apparent. 

Without addressing mental health, there will be no end to TB.