Global plan to stop tuberculosis: investment in TB control works but progress uneven.

Three of the world's six regions are expected to achieve targets for tuberculosis (TB) control, according to a World Health Organization (WHO) report published on 22 March 2006.

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The Americas, South-East Asia and the Western Pacific regions should reach targets set by the World Health Assembly to detect 70 per cent of TB cases and successfully treat 85 per cent of these cases by the end of 2005, according to the Global Tuberculosis Control 2006. The report confirms that 26 countries had already met the targets a year ahead of time, two of them being the high-TB burden countries of the Philippines and Viet Nam. It also indicates that five other high-burden countries--Cambodia, China, India, Indonesia and Myanmar--should have reached the targets within the 2005 time frame, though final confirmation will come at the end of 2006.

WHO Director-General Dr. Lee Jong-wook said: "There is clear evidence that investment in TB control works. Even in low-income countries with enormous financial constraints, programmes are operating effectively and producing results. This same commitment needs to be replicated in African countries and other areas where funding and priority for TB control remains fragile."

The latest estimates in the report suggest that 1.7 million people died from TB in 2004 and there were also 8.9 million new cases, with its number per capita rising at 1 per cent per year globally as a consequence of the TB crisis in Africa--a crisis attributed partly to the complications of HIV infection and poor health systems. Eastern Europe, with its high prevalence of multi-drug-resistant tuberculosis (MDR-TB), also continues to have an adverse impact on the global treatment success rates.

Despite the cost-effectiveness of TB control, there is concern that African leaders are still failing to seriously invest in it. Response to the 2005 TB emergency declaration in Africa has been, for the most part, far too sluggish. The report highlights the need for a much more rapid and vigorous response to the African TB emergency, including more ambitious plans that are backed up by more funding from Governments and donors. Kenya is one country that is responding to the emergency declaration's call for "urgent and extraordinary actions" to address TB and TB/HIV. Its Minister of Health, Charity Kaluki Ngilu, said: "Kenya is determined to make a difference. We are taking a strong and decisive lead in TB control through our own national TB emergency plan. This is a strategic plan that lays out the actions and resources required to reduce the misery caused by unnecessary TB deaths."

Other new initiatives, with the shared aim of improving access to TB treatments for all, were also launched in Geneva prior to World TB Day which is 24 March. A set of International Standards for Tuberculosis Care, describing the level of care all health practitioners should follow, together with a new Patients' Charter for Tuberculosis Care, outlining for the first time the rights and responsibilities of people with TB, were also released on 22 March. The two documents are important inclusions in a new six-point Stop TB Strategy developed by WHO and are highlighted in the Stop TB Partnership's Global Plan to Stop TB, 2006-2015, which was launched in January 2006.

The six components of the new Stop TB Strategy are: pursue high-quality DOTS expansion and enhancement; address TB/HIV, MDR-TB and other challenges; contribute to strengthening the health system; engage all care providers; empower the communities and people with TB; and enable and promote research. The increased momentum around TB control has been stimulated by commitments to the Global Plan to Stop TB, underpinned by the Strategy. However, for the Plan to succeed in saving 14 million extra lives, a ten-year funding gap of $31 billion must be bridged. This is equivalent to just $2 a year from every person in the industrialized world.