At the start of the twentieth century, Robert Koch spoke in London, urging a change of priorities in dealing with Tuberculosis, a disease that had plagued mankind for thousands of years. It was time to stop prioritizing prevention, and start combatting the disease, with complete eradication as the ultimate goal.
Koch’s earlier discovery of the Mycobacterium tuberculosis as the causative agent for Tuberculosis had provided a scientific foundation for the disease, yet at the time of his speech in London, the only significant response to TB had been in the form of the Sanatorium, intended to isolate and give respite to TB patients. In response to Koch’s call to action, in 1903 the Dutch Central Committee was founded in The Hague. Tasked with bringing together the fragmented landscape of TB organizations and sanatoria, the organization quickly grew and in 1907, was renamed the Dutch Central Association (NCV).
Through collaboration, an international outlook and a pioneering spirit, the NCV grew into a prominent institution, bringing together the previously decentralized efforts to prevent, cure and fight tuberculosis in the Netherlands. Global efforts in public awareness building and fundraising developed in the early 20th century, created the model which NGOs today still use. Despite these significant efforts, and while increasing standards of living were impacting the spread of TB, in the absence of a cure it seemed Koch’s dream would remain a dream for the foreseeable future.
It wasn’t until after the Second World War that effectively treating and curing Tuberculosis became a reality. After millennia of human suffering, the introduction of antibiotics represented the first effective tools in the fight against a disease that had indiscriminately claimed the lives of pharaohs, philosophers and kings alike. With a renewed fighting spirit and an effective weapon at hand, global TB-control efforts intensified. In the Netherlands, the NCV was recognized for its efforts by being granted the Dutch ‘Royal’ designation in 1953, changing the name of the organization to ‘KNCV’ (Royal Dutch Central Association).
The fifties and sixties were a time of intense development for KNCV, tasked with stopping the disease in the Netherlands, as global efforts to combat TB increased significantly. In the mid-sixties Dr. John Meijer, then Director of KNCV, publicly questioned the method required to move countries from high to low TB prevalence. This lead to the establishment of an international research body, the ‘International Tuberculosis Surveillance Research Unit’ which is still active and relevant to this day. As the sixties drew to a close, KNCV had managed to effectively reduce the incidence of TB in the Netherlands.
The seventies would be another transformative decade for KNCV. At this time, a relatively unknown Czechoslovak would first walk through the doors at KNCV and few could have predicted the impact his work would have on the lives of millions of people across the globe. Karel Styblo (1921-1998) was a quiet but persistent man, who had seen the value of directly observed treatment in practice, and urged governments to implement this form of treatment as an effective method to combat TB on a national scale, even in poorer countries. At KNCV, and later as director of the International Union Against Tuberculosis and Lung Disease, he developed what is now commonly known as the ‘DOTS (Directly Observed Treatment, Short-Course) strategy’, which the WHO would later describe as ‘the biggest health breakthrough of the decade’.
Dr. Styblo’s DOTS strategy became the recommended strategy of the WHO, revolutionizing global TB control efforts, and earning him the title ‘father of modern TB control and one of the heroes of public health of the 20th century’.
With Tuberculosis under control at home, KNCV now had the opportunity to export its experience and knowledge abroad. Over the years, KNCV became a key player in global TB control. In collaboration with the WHO, KNCV organized a gathering of representatives of European countries in the village of Wolfheze, the Netherlands. Still active today as the biennial ‘Wolfheze Workshops’ which continues to form a platform to align, share and develop TB-control strategies among European and Central-Asian countries.
Around the turn of the century, KNCV collaborated on the ‘Amsterdam Declaration’, bringing together twenty-two high-burden TB countries to recognize TB’s role and relation to poverty and commit to fighting the disease. In the wake of the declaration, KNCV, the WHO, the CDC and the Union helped found the ‘Stop TB Partnership’, bringing together TB-control organizations around the world. The Stop TB Partnership still collaborates with KNCV, and 1500 other partners, as an important collective voice for global TB-control.
Today, KNCV has grown to be the world’s largest organization exclusively dedicated to the eradication of Tuberculosis. Since 2000, KNCV has successfully led USAID’s global TB control project TBCTA from 2000-2005, followed by ‘TB CAP’ from 2005-2010 and TB CARE I which ended in 2015. Currently, KNCV leads Challenge TB, USAID’s flagship global mechanism for implementing USAID’s TB strategy as well as contributing to TB/HIV activities under the U.S. President’s Emergency Plan for AIDS Relief. As an international center for knowledge and expertise, KNCV combines its role in Dutch TB control with an international presence in roughly two dozen countries around the world. KNCV provides technical assistance that helps save lives, fight the global TB epidemic and helps realize the goal of a TB-free world that was first set by Robert Koch in 1901.