July 15, 2005
According to the World Health Organization's 2005 Global Tuberculosis Control report, global TB prevalence has declined by more than 20 percent since 1990 and incidence rates are now falling or stable in five of the six regions of the world. The exception is Africa, where TB incidence rates have tripled since 1990 in countries with high HIV prevalence, and rates are still rising across the continent at 3-4 percent annually.
Even Uganda, which has had success in reducing HIV, is today curing fewer TB patients than it did four years ago. Due to strained general health facilities, more than half of all Ugandan TB patients are without access to Directly Observed Treatment Short-Course (DOTS) services.
"Evidence in this report provides real optimism that TB is beatable, but it is also a clear warning," said WHO Director-General Dr. Lee Jong-wook. "As 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."
China and India, which account for one-third of global TB, have made major progress. Both countries have rapidly scaled up DOTS, resulting in an 8 percent increase in the number of cases treated under DOTS worldwide.
Other countries such as Indonesia and the Philippines show 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 UN Millennium Development Goal of reducing TB incidence by 2015. 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, more than 17 million TB patients have benefited from effective treatment under DOTS. But more could be achieved, including research into new diagnostics, drugs, and vaccines, if the annual US$1 billion funding gap for TB was filled. The UK-led Commission for Africa linked improved TB control to strengthened health systems and called for full funding of WHO's "Two Diseases, One Patient" strategy for improved TB and HIV intervention.
"It is a remarkable achievement that we are on target to reach the goal of halving TB cases by 2015 in most places," said UK International Development Secretary Hilary Benn. "The department for International Development is a strong supporter of TB programs in some of the countries which have been making the fastest progress. However, as both the Global TB Control report and the Commission for Africa report stress, the destructive link between TB and AIDS in Africa is causing an increase in cases. I call on the international community to step up efforts to tackle both of these diseases together."