GAINING GROUND
Global TB campaign making headway, but Africa, AIDS are big problems; Philippines remains a problem area
PARIS
Global efforts to overcome tuberculosis are making gradual headway but serious problems remain in tackling the disease in Africa and among people with HIV/AIDS.
In an annual update, the World Health Organization said that in 2003--the latest year for which figures are available--there were around 8.8 million new cases of TB. However, this is only an estimate, for only 3.9 million of the cases were formally diagnosed by laboratory tests. Of these, 674,000 also had HIV, a phenomenon that shows the worrying coexistence between TB and AIDS.
Half of the new cases occurred in six Asian countries: Bangladesh, China, India, Indonesia, Pakistan, and the Philippines.
Around 1.7 million people died of TB in 2003, including those co-infected with HIV, the report said.
"In 2003, the TB incidence rate was falling or stable in five out of six WHO regions, but growing at 1.0 percent globally," it said. "The exception is Africa, where incidence has been rising more quickly in countries with higher HIV prevalence rates.…But for the strongly adverse trends in Africa, prevalence and death rates would be falling more quickly worldwide."
In Eastern Europe, another regional hotspot, TB incidence peaked in 2001 but has since fallen.
The report paid tribute to the Directly Observed Treatment, Short Course (DOTS) strategy, which seeks to improve TB detection and treatment compliance to combat the worsening problem of resistance to mainstream antibiotics. The DOTS guidelines require caregivers to monitor patients carefully to ensure that they complete a short course of powerful drugs.
Patients with TB often fail to adhere to the drug regimen right to the end, after their symptoms disappear. That helps surviving TB germs to rebound, opening the way for that patient to fall sick again and to infect other people. It also greatly encourages the rise of resistant strains of the microbe.
More than 17 million patients took part in DOTS programs from 1995 to 2003. The WHO-initiated guidelines have now been adopted, either nationally or regionally, in 182 countries, and are helping to improve the rates for diagnosis, the report said.
Even so, a long path lies ahead.
In 2003, less than 45 percent of infectious TB cases were detected, which means that the majority of people with the disease went without treatment and were still capable of spreading it to others.
The Millennium Goals set a target of 70 percent in 2005. This target, though, seems very distant given the coinfection with HIV, which is often undiagnosed because of stigma.
A piece of good news, the WHO said, was that funding for TB in poorer countries was on the rise. Around US$2.2 billion are needed globally in 2005 to tackle the disease. Poor and transitional countries account for US$1.3 billion of this; US$1.2 billion has already been raised, thanks to additional government funding in China, Indonesia, and Russia and to grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
Other organizations pitched for greater awareness about the dangers of tuberculosis as the WHO released its report, which coincided with World TB Day on March 24.
According to the World Economic Forum's Global Health Initiative, TB costs businesses around US$12 billion in lost worker productivity each year, even though the cost of DOTS treatment per patient is as low as US$10 in some countries.
AFP
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