Why is
global TB control essential in the 21st century?
The World Health Organization
(WHO) declared the TB epidemic a global emergency in 1993. Each year,
approximately 1.5 million people die of TB, and 8 million new cases occur.
Drug
resistance is a growing problem; WHO has reported that up to 50 percent of
people with multi-drug resistant TB (MDR-TB) may die of their infection despite
MDR treatment, which can be 10 to 50 times more expensive than that used
for
drug-sensitive TB. HIV/AIDS has also contributed to the resurgence of TB.
One-quarter of the increase in TB incidence involves co-infection with HIV. TB
is expected to rank second only to HIV/AIDS as a cause of infectious disease
deaths by 2020.
From
WHO
Report 2005: Global Tuberculosis Control:
The WHO-recommended strategy
for controlling TB is called DOTS (Directly Observed Therapy, Short Course).
Although labor-intensive, this method of case management by observing patients
taking their drugs for at least the initial portion of the 6-8 month treatment
period is very cost-effective, according to the World Bank. Yet many national
TB programs lack the skills and resources to implement effective DOTS programs,
or they are overwhelmed by emerging problems such as multi-drug resistance. Thus
technical and financial assistance from developed nations is essential to control
the current epidemic of TB. Although the vast majority of TB disease
occurs in developing regions, the disease pattern in industrialized areas is
changing due to immigration, travel and declining support for the public health
infrastructure.
Coordinated TB control on
a global level is a new strategy. The Stop TB Initiative, launched in November
1998 by WHO, has evolved into a broader Global Partnership to Stop TB.
The
Partnership involves numerous organizations and individuals committed to TB
control worldwide. Several coalitions of partners have emerged to
accelerate progress in specific areas, such as DOTS expansion, new TB drug development,
and
containment of MDR-TB emergencies. In the words of Dr. Gro Harlem Brundtland,
former
Director-General of WHO, “We have a cure. We need to mobilize the world
to use
it.”
See WHO's TB Fact Sheet
at
http://www.who.int/mediacentre/factsheets/fs104/en/
For
more information on TB infection and disease, see the CDC website:
www.cdc.gov/nchstp/tb
For more information on
global TB control, see the Stop TB website:
http://www.stoptb.org/
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