Thank you, President Sampaio. Good morning, Honorable Vice-Premier Li, and Dr. Margaret Chan. And thanks to all of you here for this very warm welcome.

I am honored to be here in Beijing to announce a unique and promising partnership between the government of China and the Bill & Melinda Gates Foundation.

I want to thank the Chinese Ministry of Health for bringing us together to accelerate the global fight against TB.

I want to thank the ministers of health and representatives of more than two dozen countries for coming to Beijing to write national plans to fight TB.

I want to acknowledge Margaret Chan and the WHO for their tireless work against this disease.

Above all, I want to express my thanks to Vice Premier Li Keqiang for his leading role in China’s rising commitment to public health.

Vice Premier Li: I have been fortunate enough to travel to China many times. Each time I visit, I come away very impressed with the talent, energy, and creativity of the Chinese people. Today, you have said that the government of China will help commit these strengths to the cause of reducing TB. This is phenomenal news! If China leads in the fight against TB – developing new approaches here in China and demonstrating them to the world – we can see a dramatic drop in the number of TB deaths in the next decade.

We could also accomplish something even larger, if the world’s emerging economies – Brazil, India, South Africa, Indonesia, and China – all increase their commitment to public health. This would give us a much higher percentage of the world’s people applying their intelligence to these problems – and inventing and exporting solutions. That could disrupt old patterns of inequity and help remake the map of global health.

More than 9 million people develop TB every year; nearly 2 million people die from it; and half a million patients a year are developing TB that is resistant to drugs that have been effective for 50 years. Some recent strains have shown resistance to all drugs.

Unless we do a better job of treating TB, multi-drug-resistant TB will make up an ever-rising share of TB cases – until the ratio eventually flips.

Instead of having mostly drug-susceptible TB, we’ll have mostly drug-resistant TB. Sickness and death will multiply, and – because treating MDR-TB costs 100 times more than treating regular TB – the economics of the disease will become catastrophic.

The prospect is alarming. But I believe we will prevent it because of the convergence of two forces: urgency and innovation.

In the history of the fight against TB, we have had periods of urgency, and we have had periods of innovation. But we have not had urgency and innovation together.

In the 19th century, urgency drove people to begin treating TB in sanatoriums. But there was no serious innovation there. In the mid 20th century, we had innovation in the discovery of antibiotics, but over-confidence drained away the urgency, and research stalled – leading to a period of neglect, with no urgency and no innovation.

In the early 1990s, the WHO declared TB a global emergency. Urgency returned, and we saw the scale up of DOTS around the world, particularly here in China, which did an impressive job in scaling DOTS up nationally. The DOTS approach was an innovation, and it saved many lives. But there was no innovation in the tools. The most commonly used diagnostic test today is more than 125 years old, the vaccine was developed more than 80 years ago, and the drugs have not changed in 50 years.

There’s a slang expression in English that we use when you are caught in a fight, but you can’t use all your advantages. We say it’s: “Fighting with one arm tied behind your back.” For centuries, the world has been fighting infectious disease with one arm tied behind its back. That’s why we haven’t been winning.

I predict a future very different from the past because we are finally entering an era of urgency and innovation together. The rise of multi-drug resistant cases has restored a sense of urgency – and innovations are coming on line with the promise of better diagnostics, new drugs, better systems, and eventually, a new vaccine. Finally, we are ready to put our talent and energy into the fight.

Today, the most commonly used diagnostic test for TB detects only half of all cases. But right now we have an LED microscope that detects 65 percent of cases and allows you to make three diagnoses in the time it used to take to make one.

Today, the most commonly used diagnostic test for MDR-TB takes at least six weeks. But right now we have a much better test – one that will tell you the same day if you have resistance. If you use the slower diagnostic, the patient can go on infecting family members for weeks. If you get the one-day diagnosis, you can begin treatment immediately and prevent new infections.

Quicker, more accurate diagnoses can make a big impact against the combination of HIV and TB. People who have HIV are more likely to get active TB. And TB is the leading cause of death for people with AIDS. If we can diagnose and treat TB in people with AIDS, we can get them many more years of life to support their families, raise their children, and take care of their parents.