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Need to boost funding for TB control in worst affected countries

The countries worst hit by the worldwide tuberculosis (TB) epidemic urgently need extra help if they are to meet ambitious global targets set for the year 2005.

The 22 worst affected countries are: Afghanistan, Bangladesh, Brazil, Cambodia, China, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Kenya, Mozambique, Myanmar, Nigeria, Pakistan, the Philippines, the Russian Federation, South Africa, the United Republic of Tanzania, Thailand, Uganda, Viet Nam and Zimbabwe.

TB experts working with WHO estimate that the total cost for TB control worldwide is US$1.2 billion every year. Three-quarters of that total is already covered by countries, donors and other sources. The remaining US$300 million each year is urgently needed if the targets are to be met by 2005.

“This funding gap is clearly identified and affordable. TB is an entirely curable disease and we know that DOTS (the WHO recommended TB control strategy) is the most effective means of controlling TB worldwide. If we are to meet these targets, we must act now," said Dr Lee.

“There is great expectation, for example, from the 22 highest burden countries that the Global Fund to Fight AIDS, Tuberculosis and Malaria will give increased support to cover the existing US$300 million funding gap,” said Dr J.W Lee, Director of the STOP TB Department at the World Health Organization (WHO) in Geneva.

The World Health Assembly has set global targets of detecting 70 per cent of TB patients within the framework of DOTS programmes and successfully curing 85 per cent of these patients by 2005.

Preliminary figures for patients treated in 2000 (the last year for which figures are currently available) show that on average the cure rate in the high burden countries has reached 84 per cent, which is extremely close to the target of 85 per cent. This is a significant increase from previous years.

However, only one third of all estimated infectious cases worldwide are detected under DOTS programmes, so a rapid increase in political and financial resources is necessary to achieve the target of 70 per cent.

“This is a race against time. Poor control practices in many countries and the TB/HIV co-epidemic mean that urgent action needs to be taken to control TB. We only have three years left until the deadline for reaching the global targets. WHO calls for a scale-up of efforts to detect and treat more cases under DOTS programmes," said Dr Lee.

The implementation of national DOTS programmes has been supported world-wide by the Canadian International Development Agency (CIDA), the Dutch government, the Japanese government, USAID, the Italian Cooperation and other significant organizations and donors.

The DOTS Expansion Working Group was established, following the March 2000 Amsterdam Declaration to Stop TB, to accelerate the expansion of TB control measures and increase political commitment and financial resources to reach the global targets for TB control by 2005.

The annual meeting of the DOTS Expansion Working Group will take place in Montreal on October 6 this year in conjunction with the 33rd International Union Against Tuberculosis and Lung Disease (IUATLD) World Conference. This will allow the entire audience of the IUALTD World Conference to listen to country representatives present their TB control perspectives.

The DOTS Expansion Working Group meeting in Montreal is organized by the WHO with the collaboration of the IUATLD, the Royal Netherlands TB Association (KNCV) and USAID.

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