WHO report 2008
Global tuberculosis control
1.7 Progress towards targets for case detection and cure
Point estimates of case detection and treatment success indicate that the world as a whole failed to meet the targets for both indicators. However, measurement uncertainty allows the possibility that case detection exceeded 70% in 2006, and treatment success was only 0.3% below the target of 85% in the 2005 cohort. Both targets for case detection and treatment success were exceeded in the Western Pacific Region. South-East Asia achieved more than 85% treatment success, and case detection was just under 70%. The European Region performed worst on both indicators.
Data on both treatment success and case detection were provided by 202 countries that were implementing DOTS. In 99 countries, the rate of case detection exceeded 50% and the treatment success rate was over 70% (Figure 1.18). Of these countries, 32 appear to have reached both WHO targets. They include five HBCs: China, Indonesia, Myanmar, the Philippines and Viet Nam (Figure 1.18; Figure 1.19). Among 166 countries that provided data for both the 2004 and the 2005 cohorts, 98 (59%) showed higher treatment success rates for the 2005 cohort, and 56 of 177 (32%) improved case detection by more than 5% between 2005 and 2006.
Progress can also be directly compared with the expectations set out in the Global Plan (Table 1.8), which was designed to achieve the MDG, Stop TB Partnership and World Health Assembly targets set for 2015 (Table 1.1). The case detection rate for new smear-positive cases under DOTS in 2006, at 61%, lags behind the milestone of 65% in the Global Plan. This further reinforces the message that progress in DOTS implementation has decelerated between 2005 and 2006. The detection of smear-negative and extrapulmonary cases also lags behind the Global Plan, and by a larger amount (48% estimated for 2006 compared with the Global Plan milestone of 66%). More positively, progress in the treatment success rate is ahead of the Global Plan, at 85% compared with 83%. In addition, the absolute number of smear-positive patients treated in DOTS programmes in 2006 was higher than the number forecast in the Global Plan, due to the estimated incidence of TB in 2006 being higher than anticipated by the Global Plan.