The reason for this slowing of progress is that some national programs 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 programs. Other studies have also shown that many patients are treated by private care providers, and by non-governmental, faith-based and community organizations, thus escaping detection by the public programs.
"We've entered a new era," said Dr. Margaret Chan, WHO director-general. "To make progress, firstly public programs 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 programs, 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 percent 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
"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. Peter Piot, executive director of UNAIDS, the Joint United Nations Program 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 percent 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 $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 of the 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 March 24, Dr. Jorge 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."
Source: World Health Organization