World losing momentum in tuberculosis fight: WHO

[Guest guest]

World losing momentum in tuberculosis fight: WHO

Updated Tue. Mar. 18 2008 8:40 AM ET

The Associated Press

LONDON -- The World Health Organization says the fight against the global

tuberculosis epidemic is slowing to a crawl.

A new report from the organization says the worldwide rate of TB infection has

been declining for several years.

But between 2005 and 2006, the rate of new cases fell by less than one per cent,

far less than the annual decrease of five to seven per cent sought by health

officials.

At the same time, drug-resistant TB is growing faster than ever, the WHO said

last month.

Independent health experts criticized the WHO's TB policy as too passive, and

urged a more proactive strategy.

Dr. Marcos Espinal, executive secretary of the WHO's Stop TB Partnership is

calling the most recent decline in the overall infection rate " very modest. "

" Without new tools, we will not be able to break the back of this epidemic, " he

said, citing a lack of vaccines, outdated drugs, obsolete diagnostic tests and

overwhelmed health systems as contributing to the slowdown against TB.

In 2006, there were an estimated 9.2 million new tuberculosis cases and 1.5

million deaths, the WHO said in its report, which was based on government data

from 202 countries and regions.

India and China have the most cases, followed by Indonesia, South Africa and

Nigeria, the report said.

By region, Asia has 55 per cent of all TB cases, and Africa has 31 per cent.

WHO acknowledged its treatment programs " have not yet had a major impact on TB

transmission and incidence, " according to the report, which assessed the WHO's

efforts for the past 12 years.

WHO primarily works by recommending how governments and donors can best fight

TB, and it is up to individual countries to decide how to spend funds. Last

year, countries and donors spent about $2.3 billion on TB control. This year,

WHO estimates that $3.1 billion will be needed to identify and treat TB

patients.

The report said TB infection rates were stable in Europe, and declined about

three per cent in the United States.

In Africa, however, they were still increasing as the AIDS epidemic fuels

transmission. TB in Africa has increased at least fivefold since the 1990s.

The report said 30 million people - or 84.7 per cent of identified TB patients -

have been cured through treatment.

Espinal acknowledged that WHO may not have enough evidence to show that its

treatment strategy reduces transmission. The strategy works to cure people, he

said, not necessarily to reduce the disease's spread.

Other experts countered that if treatment rates were as high as WHO claimed,

there would be less drug-resistant tuberculosis.

Last month, WHO said drug-resistant TB was spreading faster than ever. Globally,

there are about 500,000 new cases of drug-resistant TB every year, about five

per cent of the nine million new TB cases, WHO said.

Independent experts also criticized the WHO's reporting, saying it did not take

into account those who are infected but not diagnosed, and was gathered from

governments without being verified independently.

" This is a compilation of what the countries want to show, " said Dr. Francis

Varaine, co-ordinator of Medecins Sans Frontieres' tuberculosis working group.

" Some of these data are too good to be true. "

In developing countries, WHO's main tuberculosis treatment program depends on

patients volunteering to be tested, instead of doctors seeking out patients.

WHO's Espinal estimated that only about 60 per cent of infected patients are

diagnosed.

" By the time a TB patient turns up, they have been coughing for weeks and have

probably infected most of their family, friends, work mates and anyone else they

were in contact with, " said Ruth McNerney, a TB expert at London's School of

Hygiene and Tropical Medicine. She said WHO's strategy was " like shutting the

door after the horse has bolted. "

--------------------------------------------------------------------------------

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080318/who_tb_080318/20080\

318?hub=Health