FIRST EVER DECLINE IN TB GLOBAL RATES, SAYS WHO

The number of people falling ill with tuberculosis (TB) each year is steadily declining, says the World Health Organisation (WHO). The WHO 2011 Global Tuberculosis Control Report reveals that the incidence of tuberculosis and tuberculosis related deaths are at its lowest levels for a decade.


The Report’s Findings

According to the Report, tuberculosis related illnesses fell to 8.8 million in 2010, having peaked at 9 million in 2005. Tuberculosis deaths also dropped to 1.4 million, after peaking at 1.8 million in 2003. In addition, 2009 saw 87% of patients treated cured, with 46 million successfully treated and 7 million lives saved since 1995. Margaret Chan, WHO Director-General, attributes these findings largely to increased domestic and international donor support. She states: “in many countries, strong leadership and domestic financing, with robust donor support, has started to make a difference in the fight against TB.”

Tuberculosis (TB) is a contagious disease. Like the common cold, it spreads through the air. Only people who are sick with TB in their lungs are infectious. When infectious people cough, sneeze, talk or spit, they propel TB germs, known as bacilli, into the air. A person needs only to inhale a small number of these to be infected. In 2000, 189 countries which comprised the United Nations at the time recognised the scourge posed by the disease and made the eradication of the incidence, prevalence and deaths caused by tuberculosis as one of the eight Millennium Development Goals to be achieved by 2015. It is however unlikely that this component of the Millennium Development Goals will be achieved as the Report surmises that TB mortality rates are expected to drop by 50 percent in all parts of the world except for Africa.


Fears of TB Resurgence

Despite the huge progress being made in the fight against the disease, fears still remain that the gains made thus far could be easily reversed by the emergence of multidrug-resistant TB (MDR-TB). MDR-TB is a form of TB which is resistant to the most effective anti-TB drugs and does not respond to the standard six month treatment of the disease. It is also feared that a shortfall in funding could also hamper efforts to eradicate multidrug-resistant TB.

The United Nations Secretary-General, Ban Ki-moon, warns against taking the results of the Report for granted or resting on the significant laurels recently attained in the battle against the eradication of the disease. “Fewer people are dying of tuberculosis, and fewer are falling ill. This is cause for celebration,” said Ban Ki-moon. “But it is no cause for complacency. Too many millions develop TB each year, and too many die. I urge serious and sustained support for the Stop TB Partnership in the years to come.”


The Stop TB Partnership

The Stop TB Partnership was established in 2001 with the goal of eliminating TB as a public health problem and, ultimately, to ensure a world free of TB. It comprises a network of international organizations, countries, donors from the public and private sectors, governmental and non-governmental organizations (NGOs) that have expressed an interest in working together to eliminate TB.

Frighteningly, only 16% (about 46,000) of the estimated number of people infected with MDR-TB have received treatment worldwide. This alarming statistic may be attributed to the difficulty in obtaining an early diagnosis of MDR-TB. It is hoped that the new rapid test for MDR-TB endorsed by the WHO in December 2010 will modify the current method of diagnosis made redundant by the emergence of the MDR-TB, thereby ensuring that infected individuals are diagnosed quicker and can receive treatment as soon as they have been diagnosed. At present the new rapid test for MDR-TB is being used in 26 countries and this is expected to increase significantly in the coming months. Dr Mario Raviglione, Director of WHO’s Stop TB Department recognises the urgency in ensuring that all those infected are promptly diagnosed and offered treatment. Dr Raviglione states: “But the promise of testing more people must be matched with the commitment to treat all detected. It would be a scandal to leave diagnosed patients without treatment”.


Huge Achievements and Guarding against Complacency

Amongst the countries which have seen significant declines in cases of tuberculosis over the last decade are Kenya, Tanzania and Brazil. Notably, Kenya and Tanzania, countries which have seen a remarkable decrease in tuberculosis, have also seen a fall in the incidence rates of HIV/AIDS infections over the last ten years. Tuberculosis is a major killer of people infected with the HIV virus and the WHO state that a staggering 82% of people in Africa infected with HIV in 2010 developed TB. China has seen an even more marked decrease in tuberculosis prevalence and death rates. Tuberculosis death rates in China fell to 55,000 in 2010 from 216,000 in 1990 while prevalence rates tumbled to 108 per 100,000 population from 215 per 100,000 population.

Despite the huge successes achieved in the fight against the disease so far, the results of the Report should be considered with some caution. The authors of the Report admit that a third of estimated TB cases worldwide are not notified and as such it is unknown whether they have been diagnosed and properly treated. Arguably, this factor may have skewed the results of the Report somewhat. Drug-resistant TB strains and the drop in funding for TB-related global health programmes are undoubtedly the biggest challenges facing health experts worldwide and as such complacency should be guarded against in the far from won battle against tuberculosis.