WHO warns the fight against TB has slowed down

Mar 18 2008

A new report by the World Health Organisation (WHO) on tuberculosis (TB) has revealed that the pace of the progress to control the TB epidemic has slowed down.

The WHO report also warns that more new TB cases are slipping through the detection net.

The report is the 12th annual WHO report on global TB control, and is based on data given to WHO by 202 countries and territories.

WHO director-general Margaret Chan says after some years of good trends for TB control, data from 2006 illustrates a slowing of progress in the rate at which new cases were detected and countries are failing to maintain the rapid progress made in earlier years.

Dr. Chan says this slowdown in progress comes at a time when numbers are still way too high.

According to WHO estimates only 61 percent of all TB cases worldwide are registered; in 2006, 9.2 million new cases of TB were detected as against 9.1 million in 2005.

The WHO estimates that, including non-detected cases, there were 14.4 million cases of the disease worldwide in 2006 and while between 2001 and 2005, detection rates were increasing by six percent a year, in 2006, this rate was halved to three percent.

Mario Raviglione, director of the WHO's Stop TB department, says this is not a good sign because the target is to detect all cases that exist and only 39 percent of the cases suspected to exist are found.

The WHO believes the slowdown can be attributed to the fact that some national programmes that were making steady progress during the last five years have not been able to continue at the same pace in 2006 and in many African countries, there has been no increase in the detection of TB cases through national programmes.

The WHO suggests others are slipping through the detection net as they are treated by private care providers, and by NGOs or community groups.

Dr. Chan believes that in order to make progress public programmes must be further strengthened and the potential of using other service providers should be explored.

She believes enlisting other service providers and working in partnership with national programmes, will markedly increase diagnosis and treatment for people in need.

The WHO says the significant number of HIV-infected people with TB adds to the problem - in 2006, some 700,000 new cases of HIV-infected people with TB were detected.

UNAIDS says the report clearly demonstrates how closely linked TB and HIV are as TB is the single most important cause of death for people living with HIV.

In 2006, 200,000 TB deaths were recorded among people who were infected with HIV, while an estimated 1.5 million people without HIV also succumbed to tuberculosis.

Rwanda, Malawi and Kenya have the highest HIV testing rates among African states but universal access to high-quality prevention, diagnostic, treatment and care services for HIV and TB, does not exist and TB/HIV remains a massive challenge for some countries.

Last month, the WHO issued a warning that drug-resistant strains of tuberculosis have been recorded at their highest rates ever around the globe amid shortages in funding needed to combat the disease; to date however, the response to this epidemic has been inadequate.

The WHO says almost half million new cases of multi-drug resistant tuberculosis occur each year worldwide.

The report also documents a shortage in funding despite an increase in resources, especially from the Global Fund and some middle-income countries.