OneWorld.net (U.S.)

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).

The Global Tuberculosis Control 2008, released by World Health Organization (WHO), finds that the pace of the progress to control the tuberculosis (TB) epidemic slowed slightly in 2006, the most recent year for which data were available.

The report is a comprehensive source of information about the national and international response to the worldwide TB epidemic.

This is the 12th annual WHO report on global TB control, and is based on data given to WHO by 202 countries and territories.

Between 2001 and 2005, the average rate at which new TB cases were detected was increasing by 6% per year; but between 2005 and 2006 that rate of increase was cut in half, to 3%.

The reason for this slowing 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.

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.

New challenges

The report highlights two aspects of the epidemic that could further slow progress on TB.

The first is multidrug-resistant tuberculosis (MDR-TB). Given limited laboratory and treatment capacity, countries project they will be able to provide treatment only to an estimated 10% 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.

The report analyses the implementation of WHO’s Global Plan to Stop TB 2006-2015 which establishes the targets for global TB control within the context of Millennium Development Goals (MDGs).

The Stop TB Strategy has six major components: (i) DOTS expansion and enhancement; (ii) addressing TB/HIV, MDR-TB and other challenges; (iii) contributing to health system strengthening; (iv) engaging all care providers; (v) empowering patients, and communities; and (vi) enabling and promoting research.

Till date, progress has been mixed. The first component of the strategy – the detection and treatment of new cases in DOTS programmes – fares best.

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.

This is mainly due to the higher funding requirements for collaborative TB/HIV activities, management of MDR-TB in the Global Plan, compared with country reports.

Progress in case detection slowed globally in 2006 and began to stall in China and India. The detection rate in the African region remains low in absolute terms.

The report argues that renewed effort to accelerate progress in global TB control in line with the expectations of the Global Plan, supported by intensified resource mobilisation from domestic and donor sources is needed.

Source: WHO