Sunday, 27 November 2011

TUBERCULOSIS: Underfunding Of Tuberculosis, WHO Warns Of Consequences

Grace Rattue : 26 Nov 2011 For the first time, the World Health Organization (WHO) has reported that the number of individuals who fall ill with tuberculosis (TB) each year is declining. According to new data, the number of humans dying from TB dropped to its lowest level in 10 years. However, due to underfunding this current progress is at risk, especially attempts to fight drug-resistant TB. The data is published in the WHO 2011 Global Tuberculosis Control Report.

According to the new report:
In 2010, the number of individuals who fell ill with TB dropped to 8.8 million, after reaching 9 million in 2005.
The number of TB deaths fell to 1.4 million in 2010, compared to 1.8 million in 2003.
Between 1990 and 2010, the TB death rate dropped by 40%, and apart from Africa, all regions are on track to achieve a 50% reduction in death rates by 2015.
In 2009, 87% of individuals treated for TB were cured, with 7 million lives saved and 46 million patients successfully treated since 1995. Although worldwide, a third of estimated cases are not notified, thus its unknown if these people have been diagnosed and properly treated.
United Nations Secretary-General Ban Ki-moon, explained:
"Fewer people are dying of tuberculosis, and fewer are falling ill. This is major progress. But it is no cause for complacency. Too many millions still develop TB each year, and too many die. I urge serious and sustained support for TB prevention and care, especially for the world's poorest and most vulnerable people."
A considerable amount of the progress reported is a result of increased efforts in large countries.

WHO's Director-General, Dr Margaret Chan, said:
"In many countries, strong leadership and domestic financing, with robust donor support, has started to make a real difference in the fight against TB. The challenge now is to build on that commitment, to increase the global effort - and to pay particular attention to the growing threat of multidrug-resistant TB."
The United Republic of Tanzania and Kenya are among these countries. In these nations in Africa, the burden of tuberculosis is estimated to have been declining for the majority of the past 10 years, after a peak, which was associated with the HIV epidemic. Since 1990, Brazil has reported a considerable and sustained decline in its TB burden. The decline in the TB death rate in China has been significant, falling by nearly 80% between 1990 and 2010, with deaths declining from 216,000 in 1990, to 55,000 in 2010. During the same period, the prevalence of TB halved, from 215 to 108 per 100,000 population.
Globally, the share of domestic funding assigned to tuberculosis increases to 86% for 2012. However, the majority of low-income countries still strongly depend on outside funding. Overall, for tuberculosis implementation in 2012, nations have reported a US$1 billion deficit in funding.
One of the most underfunded areas continues to be treating multidrug-resistant TB (MDR-TB). Even though in 2010 the number of MDR-TB patients rose to 46,000, this is only 16% of the estimated number of MDR-TB patients that needed treatment.

Dr. Mario Raviglione, Director of WHO's Stop TB Department, explains:
"A new rapid test for MDR-TB is revolutionizing TB diagnosis with 26 countries using the test only six months after its endorsement by WHO last December, with at least ten more countries expected to have it by the end of 2011. But the promise of testing more people must be matched wih the commitment to treat all detected. It would be a scandal to leave diagnosed patients without treatment."
HIV-positive individuals, who are also infected with the bacteria causing TB, are up to 34 times more likely to develop tuberculosis. In 2010, 1.1 million HIV-positive patients developed the disease - out of which 900,000 (82%) of them were in Africa.
Although progress in addressing the TB/HIV co-epidemic is been acheived, with coverage of testing for HIV increased to 59% of patients with TB in Africa, more commitment is required in order to reach key 2015 tuberculosis targets.

In 2010, nearly half of all patients with TB who tested positive for HIV in Africa were taking antiretrovirals, and approximately three-quarters of these patients started co-trimoxazole preventive therapy, which helps to reduce mortality. Both of these treatments are some the important elements of TB/HIV care.
Furthermore, the report highlights promising developments in tuberculosis vaccines, diagnosis and medications. Among these developments, there are strong expectations for shortened drug regimens. Results from two Phase II trials of novel MDR-TB medications are expected in 2012, and results from three Phase III drug trials are expected between 2012-2013.
The WHO 2011 global tuberculosis control report, data on TB and its prevention, care and control were submitted to WHO by 198 countries. Profiles for these nations are included in the report.
MDR-TB is caused by bacteria that are resistant to the most effective anti-TB medications isoniazid and rifampicin. MDR-TB does not respond to the standard 6 month treatment with first-line anti-TB medications and can take more than two years to treat with medications that are less powerful, significantly more expensive and more toxic.

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