TB cases at alarming levels in Africa
-------------------------------------
Stop TB Partnership, WHO Stop TB Department
24 March, 2005
Rising TB rates contrast sharply with accelerated progress in
other regions
In most areas of the world, the battle against tuberculosis is
being successfully fought, but in Africa the disease has reached
alarming proportions with a growing number of TB cases and
deaths linked to HIV, the World Health Organization (WHO) said
in a new report released today.
The Global Tuberculosis Control report for 2005 finds that
global TB prevalence has declined by more than 20% since 1990
and that incidence rates are now falling or stable in five of
the six regions of the world. The glaring exception is Africa,
where TB incidence rates have tripled since 1990 in countries
with high HIV prevalence and are still rising across the conti-
nent at a rate of 3-4% annually.
Even Uganda, an African HIV reduction success story, is today
curing fewer TB patients than it did four years ago. More than
half of all people with TB in Uganda remain without access to
life-saving DOTS [1] services due to strained general health fa-
cilities.
"Evidence in this report provides real optimism that TB is beat-
able, but it is also a clear warning," said WHO Director-General
Dr LEE Jong-wook. "As Nelson Mandela has said, we can't fight
AIDS unless we do much more to fight TB, and it is time to match
his words with urgent action in Africa on the two epidemics to-
gether."
There has been major progress in China and India, which account
for one third of the global TB burden. Both are leading the ac-
celerated response to TB control by rapidly scaling up DOTS. As
a result, the number of cases treated under DOTS worldwide rose
8% in 2003 compared to the previous year. Other countries such
as Indonesia and the Philippines are showing similar progress.
Assuming strong commitment and resources are sustained, four re-
gions - the Americas, Eastern Mediterranean, South East Asia and
Western Pacific - are on track to reach the United Nations Mil-
lennium Development Goal of reducing TB incidence by 2015. The
two exceptions are Africa due to the TB/HIV co-epidemic, and
Europe where there are high levels of multidrug-resistant TB and
slow advances in DOTS in countries of the former Soviet Union.
"Dedicated frontline health workers are making a difference,
reaching out to the most vulnerable," said Dr Mario Raviglione,
Director of WHO's Stop TB Department. "But we need to push even
further, to work with new partners in both public and private
health sectors, and in all regions, to reach more than half of
all patients that are still without access to DOTS treatments."
Since 1995, over 17 million people with TB have benefited from
effective treatment under DOTS. But more could be achieved
within countries, and in research into new diagnostics, drugs
and vaccines, if the annual US$ 1 billion funding gap for TB
control was filled.
The urgency of addressing TB has been highlighted in the UK-led
Commission for Africa, which linked improved TB control to
strengthened health systems, as well as calling for full funding
of WHO's 'Two Diseases, One Patient' strategy for improved TB
and HIV intervention.
"It is a remarkable achievement that we are on target to reach
the goal of halving TB cases by 2015 in most places," said the
UK's International Development Secretary, Hilary Benn. "The De-
partment for International Development is a strong supporter of
TB programmes in some of the countries which have been making
the fastest progress. However, as both the Global TB Control re-
port and the Commission for Africa report stress, the destruc-
tive link between TB and AIDS in Africa is causing an increase
in cases. I call on the international community to step up ef-
forts to tackle both of these diseases together."
--
[1] DOTS is the internationally recommended strategy for con-
trolling TB, consisting of five elements:
* Government commitment to TB control
* Diagnosis through bacteriology and an effective lab network
* Standardized short-course chemotherapy with full patient sup-
port throughout treatment
* Uninterrupted supply of quality-assured drugs
* Recording and reporting to measure patient and programme out-
comes
World TB Day on March 24th is a Stop TB Partnership initiative
aimed at raising TB awareness internationally. WHO is one of 325
members of the Stop TB Partnership committed to controlling and
ultimately eliminating TB as a public health problem. Since the
Partnership's formation in 2001 the number of patients detected
for TB has increased by two thirds.
For more information contact:
Michael Luhan
Stop TB Partnership
Tel: +91-98-1899 8485
Mobile phone: +41-79-509-0643
mailto:lunham@who.int
Glenn Thomas - Communication Officer
Stop TB Department WHO, Geneva
Tel: +41-22-791-3983
Mobile phone: +41-79-509-0677
mailto:thomasg@who.int
Michel Aublanc
Tel: +33-1-69-286 286
mailto:M.aublanc@public-info.org