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        The world is coming to terms with the reality of a pandemic of respiratory illness due to the novel coronavirus, COVID-19. Due, in part, to aggressive disease control measures in China, the early spread of the virus outside China was slow but it is now clear that there is sustained community transmission established in many countries. The entire world is in for a rough ride in the next few months with serious health, social and economic consequences for individuals, nations and the world.

        As we steel ourselves as a global community to take on, and overcome, this new and significant challenge, we must look for areas of public health synergy wherever possible, including keeping the following facts about world lung health in mind: that more people die of tuberculosis (TB) every day than have died from COVID-19 to date; that every day on average about 1000 people die from influenza and 2000 children under the age of five years die from pneumonia.

        The World Health Organization (WHO) is responsible for the international health-sector response to COVID-19 and, along with national public health agencies, is providing valuable technical advice. The Union, the world’s oldest global non-government organisation devoted to public health, strives to end suffering due to TB and lung disease by advancing better prevention and care. We are committed to achieving this by the generation, dissemination and implementation of knowledge into policy and practice. We aim to ensure that no-one is left behind and that resources and opportunities are fairly shared. With this mission in mind, we make the following calls and commitments:

        1. The burden of this crisis must be borne fairly by the global community. Those who have little, have least capacity to bear additional costs. We must ensure that access to tests, medications and vaccines, when they are available, is equitable and not limited by capacity to pay. We need to ensure that those who are most vulnerable, both individuals and nations, are protected from severe economic consequences.

        2. Control of transmission of the virus will require public health actions including isolation of infected, and potentially infected, individuals, social distancing and some changes in personal behaviour. It is likely that this will require some curtailment of individual liberties. It is important that these actions are implemented by authorities in a manner that is appropriate to the local epidemiological situation and is proportionate. Excessive and unnecessary restrictions should be avoided. At all times, authorities should seek to maximise both respect for the rights and needs of individuals and the protection of public health.

        3. We have learned from our experience with TB of the effects of stigma on people with or at risk of disease and the importance of the language we use when describing the illness. We have seen the similar use of stigmatising language by the media and others when discussing people who have COVID-19. It is important that we adhere to the language guidance issued by WHO, which mirrors many of the lessons we have learned in TB to minimise stigma experienced by people affected by COVID-19.

        4. Both transparency and truth are important values at these challenging times. It is important that authorities are open about the impact of the epidemic and the actions required to control it.

        5. There are many unanswered questions about how best to deal with this novel problem. It is important that rigorous scientific methods are applied, with adequate resourcing, to ensure that the best tools, policies and procedures for mitigating the problems caused by COVID-19 are rapidly identified, validated, implemented and scaled up. This involves basic and laboratory science, epidemiological, operational and clinical research methods. The knowledge gained in these endeavours should be public and openly disseminated.

        6. It is likely that COVID-19 has arisen from an as-yet-unidentified animal source, as have other recent outbreaks such as SARS, MERS and Ebola. A One Health approach to disease control should be embraced, as it recognises the importance of the intersection of humans, other animals and the environment.

        7. The Union undertakes to use its resources, including its membership network, its conferences, webinars and publications, its communications team and its technical team to support the global response to the challenge of COVID-19.

        José Luis Castro, Executive Director

        Dr Keren Middelkoop, Chair, Coordinating Committee for Scientific Activities

        Prof Guy B Marks, President

        On behalf of the International Union Against Tuberculosis and Lung Disease (The Union)

         

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