Africa shows alarming rise in tuberculosis, UN reports on World TB Day

24 March 2005
TB patients take treatment as part of DOTS strategy

With 5,000 people dying from tuberculosis every day and Africa posing the “glaring exception” to a global trend of falling or stabilized rates, the United Nations today observed World TB Day with an optimistic report on the battle against the disease in the world’s other regions and calls for even greater efforts.

“Clearly, we must work harder if we are to achieve, by 2015, the Millennium Development Goal (MDG) of halting and beginning to reverse the spread of TB as one of the world’s major diseases,” Secretary-General Kofi Annan said in a message in which he called the scourge “both preventable and curable.”

In most areas of the world, the battle is being successfully fought, but in Africa the disease has reached alarming proportions with a growing number of TB cases and deaths linked to HIV, the UN World Health Organization (WHO) said in its new report released today – “The Global Tuberculosis Control study for 2005.”

Global TB prevalence has declined by more than 20 per cent since 1990 and rates are now falling or stable in five of the world’s six regions of the world, but “the glaring exception is Africa,” where incidence has tripled since 1990 in countries with high HIV prevalence and are still rising across the continent at a rate of 3 per cent to 4 per cent annually, according to the report.

“Evidence in this report provides real optimism that TB is beatable, but it is also a clear warning,” WHO Director-General Dr Lee Jong-wook said. “As (former South African President) Nelson Mandela has said, we can’t fight AIDS unless we do much more to fight TB, and it is time to match his words with urgent action in Africa on the two epidemics together.”

Even Uganda, an African HIV reduction success story, is today curing fewer TB patients than it did four years ago. More than half of all people with TB in Uganda remain without access to life-saving DOTS services due to strained general health facilities.

DOTS, the internationally recommended strategy to control TB, combines five elements: political commitment, microscopy services, drug supplies, surveillance and monitoring systems, and the use of highly efficacious treatment regimes with direct observation of treatment.

There has been major progress in China and India, which account for one third of the global TB burden and have rapidly scaled up DOTS. As a result, cases thus treated worldwide rose 8 per cent in 2003 compared to the previous year. Other countries such as Indonesia and the Philippines are showing similar progress.

Assuming strong commitment and resources are sustained, four regions – the Americas, Eastern Mediterranean, Southeast Asia and Western Pacific – are on track to reach the Millennium Development Goal. The two exceptions are Africa, due to the TB/HIV co-epidemic, and Europe, where there are high levels of multi-drug-resistant TB and slow advances in DOTS in countries of the former Soviet Union.

Since 1995, over 17 million people with TB have benefited from effective treatment under DOTS, but more could be achieved within countries, and in research into new diagnostics, drugs and vaccines, if the annual $1 billion funding gap for TB control was filled.

“To achieve worldwide impact, more is needed,” Mr. Annan said in his message. “And we must provide greater support for the increasingly wide range of caregivers who help find people ill with TB and assist them with treatment. These providers include not just public health doctors and nurses, but also community leaders, former patients, women’s groups, and many others.”

WHO regional offices marked the Day with special activities, supporting symposiums, fundraising events and the distribution of educational posters. UN representatives on the front line joined in the effort. In Afghanistan, for instance, spokesperson Ariane Quentier drew attention to the severe problem TB poses, with 18,402 Afghans diagnosed with TB last year, 67 per cent of them women.


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