Policy

Ineffective action in controlling TB causing 1.6 million deaths each year

12 December 2007

TB is treatable, but inadequate action by governments worldwide is leading to escalating cases of drug-resistance, of which only 2% are treated. TB is an avoidable human tragedy of 9 million infected people and 1.6 million deaths each year.

Public health advocates meeting as the annual World Conference on Lung Health in November concluded that current approaches to diagnosing and treating tuberculosis are ineffective and do not reach the majority of people with drug-resistant TB, particularly in regions with high HIV rates.

The advocates, including the Open Society Institute (OSI), Treatment Action Campaign (TAC), AIDS & Rights Alliance for Southern Africa (ARASA), Partners In Health (PIH) and Médecins Sans Frontières (MSF), met with global leaders to discuss TB control to explore community-based solutions to stem the spread of multidrug-resistant tuberculosis (MDR-TB) and to encourage patients to take their full course of antibiotics.

“TB is a treatable disease but for far too many people it has become a death sentence,” said George Soros, chairman of OSI. “Global leaders should use this week’s World Conference on Lung Health to move away from empty rhetoric and commit to real programs that can save countless lives.”

According to the World Health Organization (WHO), there are nearly 9 million cases of TB worldwide every year, resulting in 1.6 million deaths. Failure to properly address TB has led to drug-resistant strains of the disease, which are more complicated and costly to diagnose and treat. About 420,000 new cases of drug-resistant TB are diagnosed each year, but only 2% of these cases receive treatment under the current system.

TB is also the leading killer of people living with HIV/AIDS. The WHO estimates that up to 80% of TB patients in sub-Saharan Africa are living with HIV.

The groups said that poor infection control measures in healthcare facilities, such as inadequate ventilation, are contributing to the spread of MDR-TB. Many countries lack the human resources or finances to adequately address drug-resistant TB. In southern Africa, health providers have expressed frustration over shortages of drugs that have been shown to effectively treat drug-resistant TB.

“In a recent visit to Swaziland, I saw with my own eyes the challenge of diagnosing MDR-TB in rural areas and the enormous difficulties of treating the poorest of the poor who are unable to access proper care,” said WHO Stop TB Director Dr Mario Raviglione.

“Only decisive action by governments, and through partnerships with faith-based organizations and NGOs, and the full engagement of civil society and activists, will we alleviate some of the suffering in these countries.”

There are a number of new initiatives underway to improve the prevention, diagnosis, and treatment of MDR-TB in regions with high HIV rates. For example, PIH established treatment programs in Lesotho and Rwanda that train local villagers to become community health workers. TAC and ARASA are coordinating treatment literacy campaigns in Lesotho. Governments and international donors should devote funds to exploring these and other innovative approaches to controlling MDR-TB, say the groups.

Further information

Information on the satellite meeting in Cape Town, Time for Change: New Approaches for Managing Drug-Resistant TB in Regions with High HIV Rates, is online at www.soros.org/timeforchange 

Further information on the TB pandemic

WHO Tuberculosis Programme
http://www.who.int/tb/en/

The Stop TB partnership
www.stoptb.org/

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