Gains in TB control, but not the end of TB we’re all longing for…

In the run up to the Union Conference, WHO’s Global TB Programme released the Global TB Report 2013 showing the sort of incremental improvements in TB control to which the TB world has become all too accustomed.

The report plots out the progress made towards 2015 global TB-related targets set within the context of the Millennium Development Goals (MDGs) and set priorities for actions needed to achieve and/or move beyond the MDGs.

The rate of new TB cases have been falling globally, for a decade but at a very slow rate — only 2% per year

The TB mortality rate has been reduced by 45% since 1990 — close to meeting the MDG goal of a 50% reduction in TB-related deaths.

But the number of people dying from TB each year is shocking. In 2012, an estimated 8.6 million people developed TB and 1.3 million died from the disease (including 320 000 deaths among HIV-positive people).

Figures like these explain why the activists are angry —why a ‘business as usual’ approach to ‘TB Control’ can no longer be tolerated.

What progress there has been has been very uneven as well. Of the 22 high TB burden countries (HBCs) that account for about 80% of the world’s TB cases, only seven have met all 2015 targets for reductions in TB incidence, prevalence and mortality, with four others on track.

The African and European regions are not on track to achieving the mortality and prevalence targets. In the case of the African regions, generalised HIV epidemics and resource constraints have presented major challenges to TB control (although some countries have made great strides managing TB-HIV). In the European regions, particularly Eastern Europe — the problem is multidrug-resistant TB (MDR-TB), and the countries’ unwillingness to provide in evidence-based care and management to people who inject drugs.

“Progress towards targets for diagnosis and treatment of MDR-TB is far off-track,” according to the Global TB Report. Only about a quarter of the cases are being diagnosed.

The report listed five priority actions required to accelerate progress towards 2015 targets:

  • Reach the missed cases
  • Address MDR-TB as a public health crisis
  • Accelerate the response to TB/HIV
  • Increase financing to close all resource gaps (right now, global funding for TB control is at least a couple billion dollars short)
  • Ensure rapid uptake of innovations

We will write more about what actions will be needed in our upcoming coverage of 44th Union World Conference on Lung Health going on this weekend in Paris.


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