TB control slowing: WHO report

[Guest guest]

TB control slowing: WHO report

Wednesday, March 19, 2008 18:00 IST

Geneva

The global fight to curb tuberculosis has been slowed down during the last

couple of years, according to the latest report of World Health Organisation

(WHO). The report Global tuberculosis control 2008 specifies a slow progress in

the overall development in TB diagnosis and control.

The new information documents a slowdown in progress on diagnosing people with

TB. Between 2001 and 2005, the average rate at which new TB cases were detected

was increasing by 6 per cent per year; but between 2005 and 2006 that rate of

increase was cut in half, to 3 per cent.

The reason for this slowing down of progress is that some national programmes

that were making rapid strides during the previous five years have been unable

to continue at the same pace in 2006. Moreover, in most African countries there

has been no increase in the detection of TB cases through national programmes.

Other studies have also shown that many patients are treated by private care

providers, and by non-governmental, faith-based and community organisations,

thus escaping detection by the public programmes.

" We've entered a new era, " said Dr Margaret Chan, WHO director-general. " To make

progress, firstly public programmes must be further strengthened. Secondly, we

need to fully tap the potential of other service providers. Enlisting these

other providers, working in partnership with national programmes, will markedly

increase diagnosis and treatment for people in need. "

This is the 12th annual WHO report on global TB control, and is based on data

given to WHO by 202 countries and territories. There were 9.2 million new cases

of TB in 2006, including 700 000 cases among people living with HIV, and 500 000

cases of multi-drug resistant TB (MDR-TB). An estimated 1.5 million people died

from TB in 2006. In addition, another 200 000 people with HIV died from

HIV-associated TB.

The report highlights two aspects of the epidemic that could further slow

progress on TB. The first is multidrug-resistant tuberculosis (MDR-TB), reported

by WHO last month to have reached the highest levels ever recorded. To date,

however, the response to this epidemic has been inadequate. Given limited

laboratory and treatment capacity, countries project they will provide treatment

only to an estimated 10 per cent of people with MDR-TB worldwide in 2008.

The second threat to continued progress is the lethal combination of TB and HIV,

which is fuelling the TB epidemic in many parts of the world, especially Africa.

Although TB/HIV remains a massive challenge, some countries are making strides

against the co-epidemic. Almost 700 000 TB patients were tested for HIV in 2006,

up from 22 000 in 2002 - a sign of progress but still far from the 2006 target

of 1.6 million set by the Global Plan to Stop TB 2006-2015. The three African

countries achieving the highest HIV testing rates in TB care settings in 2006

were Rwanda (76 per cent), Malawi (64 per cent) and Kenya (60 per cent).

" The report tells us that we are far from providing universal access to

high-quality prevention, diagnostic, treatment and care services for HIV and

TB, " said Dr Piot, executive director, UNAIDS, the Joint United Nations

Programme on HIV/AIDS. " Clear progress has been made but we must all do more to

make a joint approach to reducing TB deaths among people with HIV a reality. "

The report also documents a shortage in funding. Despite an increase in

resources, especially from the Global Fund and some middle-income countries, TB

budgets are projected to remain flat in 2008 in almost all of the countries most

heavily burdened by the disease. Ninety countries in which 91 per cent of the

world's TB cases occur provided complete financial data for the report. To meet

the 2008 targets of the Global Plan to Stop TB, the funding shortfall for these

90 countries is about US$ 1 billion.

" We look forward to working with all partners to further assist countries to

achieve TB targets for 2015 and beyond, " said Dr Michel Kazatchkine, executive

director, Global Fund to Fight AIDS, Tuberculosis and Malaria. " Together we are

bringing hope to the individuals and communities suffering from the enormous

burden of TB. " In recognition of World TB Day on 24 March, Dr Sampaio,

former President of Portugal and the UN Secretary-General's Special Envoy to

Stop TB, called for enhanced leadership to address TB/HIV. " TB is a leading

cause of death among people living with HIV/AIDS, " he said. " Several countries

have shown that targets relating to TB/HIV are achievable and have put in place

measures that will have an impact on the lives of those at most risk. But this

is a restless battle. We still need to do much more and much better. "

Dr.Ashok Rau

Executive Trustee/CEO

Freedom Foundation-India, Nigeria, and Botswana

(Centers of Excellence- Substance Abuse & HIV/AIDS)

Head Office: 180, Hennur Cross, Bangalore - 560043, India

Senior Research Fellow, TheTerry Sanford Institute of Public Health,Duke

University(USA)

Visiting Faculty, Yale University (USA)

Phone (O) +91 80 25440134, 25449766, 25430611

Fax (O) +91 80 25440134

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