2013 WHO Global Tuberculosis Report launched
Drug resistance and missed patients risking control
The World Health Organization (WHO) unveiled 5 priority actions to strengthen the fight against one of the world’s leading infectious killers - tuberculosis (TB) - at the 23 October launch of a new report on the epidemic. The 2013 TB report calls for more attention to multidrug-resistant TB (MDR-TB) and reaching those who are being missed by the system.
The WHO-recommended actions are based on new data from almost 200 countries and territories. It documents how TB treatment has saved the lives of more than 22 million people, and how both the numbers of people ill with TB and those who died from the disease fell in 2012.
The report also identifies the challenges still ahead to help control the disease. Around 3 million people (equal to 1 in 3 people falling ill with TB) are currently being ‘missed’ by health systems. In addition, the response to test and treat all those affected by multidrug-resistant TB (MDR-TB) is inadequate.
Insufficient resources for TB are at the heart of both challenges. TB programmes do not have the capacity to find and care for people who are “hard-to-reach”, often outside the formal or state health system. Weak links in the TB chain (a chain that includes detection, treatment and care) lead to these people being missed.
WHO estimates that 450 000 people fell ill with MDR-TB in 2012 alone. China, India and the Russian Federation have the highest burden of MDR-TB followed by 24 other countries.
A further challenge identified relates to the TB and HIV co-epidemic. While there has been significant progress in the last decade in scaling-up antiretroviral treatment for TB patients living with HIV, less than 60% were receiving antiretroviral drugs in 2012. This, the report urges, must improve.
Five priority actions
The WHO report recommends five priority actions that could make a rapid difference between now and 2015:
- Reach the 3 million TB cases missed in national notification systems by expanding access to quality testing and care services across all relevant public, private or community based
- Address with urgency the MDR-TB crisis -- Failure to test and treat all those ill with MDR-TB carries public health risks and grave consequences for those affected. High-level political commitment, ownership by all stakeholders, adequate financing and increased cooperation are needed to solve bottlenecks in drug supply and build capacity to deliver quality care.
- Intensify and build on TB-HIV successes to get as close as possible to full antiretroviral therapy (ART) coverage for people co-infected with TB and HIV.
- Increase domestic and international financing to close the resource gaps – now estimated at about US$ 2 billion per year – for an effective response to TB in low- and middle-income countries. Full replenishment of the Global Fund is essential, given that most low-income countries rely heavily on international donor funding, with the Global Fund providing around 75% of financial resources in these countries.
- Accelerate rapid uptake of new tools – through technology transfer and operational research to ensure that countries and communities most at risk benefit from these innovations.
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