According to the WHO 2017 Global Tuberculosis (TB) Report, 10.4 million people fell ill with TB in 2016 resulting in 1.8 million deaths, making TB the top infectious killer worldwide.
In Lao PDR, there were an estimated 12,000 new TB cases and 3,000 deaths due to TB in that same year. While anyone can contract TB, the disease thrives among people living in poverty, communities and groups that are marginalized, and other vulnerable populations. These includes elderly, marginalized women and children, migrants, refugees, ethnic minorities, miners and others working and living in risk-prone settings and prisons.
Factors such as malnutrition, poor housing and sanitation, compounded by other risk factors such as tobacco and alcohol use and diabetes, affect vulnerability to TB and access to care. The emergence and transmission of multidrug-resistant TB (MDR-TB) poses a major health security threat and could risk gains made in the fight against TB.
The first WHO Global Ministerial Conference on Ending Tuberculosis in Sustainable Development Goals (SDGs) era convened on November 2017 in Moscow, Russia Federation. Assoc. Prof Dr. Bounkong Syhavong, Health Minister attended the conference which calls for global leaders to intensify efforts in TB prevention and control including care and treatment for TB patients.
In line with the SDGs, eight thematic areas were introduced during the Global Ministerial Conference in Moscow to track the progress of TB control programme at the country levels; (1) universal coverage of TB care and prevention, (2) sustainable financing for TB, UHC and social protection, (3) respect for equity, ethnics and human rights, (4) scientific research and innovation (5) monitoring and evaluation of the progress, (6) action on anti-microbial resistance, health security and multi-drug resistance (MDR) TB, (7) stepped-up TB/HIV response, (8) synergies across the responses to TB and non-communicable diseases.
Following the conference, the theme for World TB Day this year was agreed “Wanted: Leaders for a TB-free world.” Political will is needed from Heads of States, Ministers of Health, parliamentarians, religious and community leaders, health professionals, civil society, NGOs and partners on building commitment to end TB.
Dr Juliet Fleischl, WHO Representative said that “WHO calls on governments to provide access to TB testing and treatment, where and when they need them, without suffering financial hardship. Reducing costs and other barriers makes those infected with TB more likely to seek treatment early. As a result, they will recover faster, diminishing the chances of spreading the disease, and be able to resume healthy, productive lives.”
In parts of the Western Pacific Region, up to 60 per cent of TB patients and their families face catastrophic costs—that is, more than 25 per cent of household income goes on treatment. The financial burden includes not only costs such as hospitalization and medicine, but also non-medical costs such as transportation and lodging and loss of income while receiving care. By 2020, no family should face catastrophic costs due to TB, according to the End TB Strategy targets.
The TB rate is coming down in the Region, but it’s not happening fast enough. The Ministry of Health has achieved remarkable progress in increasing diagnosis and treatment of TB over the past years. The National TB Centre has scaled-up the WHO recommended rapid testing of TB (with GeneXpert) for half of the presumptive TB people examined in 2017 and has conducted additional outreach screening of TB by chest X-ray for 22,295 high-risk people, testing 5,060 by GeneXpert, and diagnosing 1,033 new TB cases in 54 different sites. As a result, 5,730 TB cases were notified and started on treatment in 2017, nearly 50% of the estimated new TB cases (compared to 4,638 TB cases and 37% treatment coverage in 2015).
However, in order to reduce further TB incidence and death, and to reach the 70 per cent TB treatment coverage target in 2020, the government needs to provide equal access for the vulnerable population, to ensure that the essential health service package integrates TB diagnosis and cares in all health facilities and that all TB patients are covered by health insurance. As TB continues to affect the poor, removing catastrophic costs in accessing TB cares is key for ending the vicious cycle of poverty and ill-health.
World TB Day provides the opportunity to shine the spotlight on the disease and mobilize political and social commitment to accelerate progress to end TB. Governments are beginning to realize that investing in universal health coverage actually saves money in the long run.
TB case finding activity at the community level 
Doctor participating in a TB case finding outreach event examining a small boy