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As countries mark World Tuberculosis Day on March 24, the World Health Organization (WHO) is calling for “global solidarity and action” to support a new 20-year strategy, which aims to end the global tuberculosis epidemic. Recent years have seen tremendous progress in the fight against TB, with over 37 million lives saved, but much more needs to be done. In 2013, 9 million people fell ill with TB, almost half a million of whom have a multi-drug resistant disease which is far harder to treat. An estimated 1.5 million people still die of tuberculosis each year.
The disease frequently has devastating economic consequences for affected families, reducing their annual income by an average of 50 percent, and aggravating existing inequalities.
“This is a matter of social justice, fundamental to our goal of universal health coverage. Each and every man, woman or child with TB should have equal, unhindered access to the innovative tools and services they need for rapid diagnosis, treatment and care,” says Dr. Margaret Chan, WHO director-general.
WHO’s End TB Strategy, adopted by governments at the World Health Assembly last year, is designed to drive action in three key areas: integrated patient-centred TB care and prevention for all in need, including children; bold policies and supportive systems; and intensified research and innovation.
The strategy sets ambitious targets of a 95 percent reduction in TB deaths and a 90 percent reduction in cases of TB by 2035. An important milestone to be reached within the next five years (2020) is the elimination of catastrophic costs for TB patients and their families. Eliminating catastrophic costs is feasible through making care more accessible and through financial protection schemes to minimize medical and non-medical costs as well as income loss.
2015 is seen as a critical year for action to adapt and roll out the strategy in diverse country settings. Achieving success for the strategy will require the TB community around the world to work together to leverage alliances and resources.
“The progress that has been made in combating TB has been hard won and must be intensified if we are to wipe out the TB epidemic,” says Dr. Eric Goosby, who was appointed UN Special Envoy on TB in January this year. “The End TB Strategy offers new hope to the millions of people suffering and losing their lives to TB each year. It is time to join forces to create a world free of TB.”
The strategy addresses tuberculosis among vulnerable groups, including people living with HIV who develop TB. In 2013 there were an estimated 1.1 million people co-infected with HIV and TB, 360 000 of whom died.
Persistent funding gaps in the TB response also need to be filled to drive progress toward ending the global epidemic. It is vital that resource gaps of $2 billion per year for TB interventions and $1.39 billion per year for TB research be filled. Accelerating research and innovation in basic science, new diagnostics, drugs and vaccines and their rapid uptake, will be critical to break the trajectory of the epidemic and reach the global targets.
“This World TB Day should serve to alert and mobilize as many people as possible to end the epidemic,” says Dr. Mario Raviglione, director of the WHO Global TB Program. “We must work with innovators in health, development, civil society and the private sector to end the burden of this preventable disease.”
Gearing up to adapt and implement the End TB strategy has already begun. A new action framework targeting the elimination of TB for low-incidence countries was launched last year. Regions are working on plans to support countries, and ministries of health are updating their national plans in line with the strategy and its milestones.
An article on the action framework toward tuberculosis elimination for low-incidence countries will be published today by the European Respiratory Society (ERS) and WHO.