signals urgent need for greater political commitment to end tuberculosis
remains leading infectious killer
30 OCTOBER 2017 |
GENEVA - Global efforts to combat tuberculosis (TB) have saved an
estimated 53 million lives since 2000 and reduced the TB mortality rate
by 37%, according to the Global TB Report 2017, released by WHO today.
achievements, the latest picture is grim. TB remains the top infectious
killer in 2016. TB is also the main cause of deaths related to
antimicrobial resistance and the leading killer of people with HIV.
Progress in most countries is stalling and is not fast enough to reach
global targets or close persistent gaps in TB care and prevention.
"While the world
has committed to ending the TB epidemic by 2030, actions and
investments don?t match the political rhetoric. We need a
dynamic, global, multisectoral approach." said Dr Tedros Adhanom
Ghebreyesus, Director-General of WHO. "The good news is that we finally
have two great opportunities to move forward: the first WHO Global
Ministerial Conference to End TB in Moscow in 2017, followed by the
first UN General Assembly High-Level Meeting on TB in 2018. These will
build momentum, get different sectors engaged, and accelerate our
efforts to make TB history."
burden of disease and death in 2016
In 2016, there
were an estimated 10.4 million new TB cases worldwide, 10% of which
were people living with HIV. Seven countries accounted for 64% of the
total burden, with India bearing the brunt, followed by Indonesia,
China, Philippines, Pakistan, Nigeria and South Africa. An estimated
1.7 million people died from TB, including nearly 400 000 people who
were co-infected with HIV. This is a drop by 4% compared to 2015.
TB (MDR-TB) remains a public health crisis and a health security
threat. WHO estimates that there were 600 000 new cases with resistance
to rifampicin ? the most effective first-line drug, of which
490 000 had MDR-TB. Almost half of these cases were in India, China and
the Russian Federation.
numbers of deaths and suffering speak for themselves ? we are
not accelerating fast enough," said Dr Mario Raviglione, Director of
the WHO Global TB Programme. "Prompt action towards universal health
coverage and social protection, as well as breakthroughs in research
and innovations ? will be critical to enable access to
patient-centered care of the highest standards for all, especially the
poorest, most disadvantaged people everywhere."
in care and financing
epidemic requires action to close gaps in care and financing. It also
requires progress in a particular subset of high TB burden countries
and underdiagnosis of TB cases continues to be a challenge, especially
in countries with large unregulated private sectors and weak health
systems. Of the estimated 10.4 million new cases, only 6.3 million were
detected and officially notified in 2016, leaving a gap of 4.1 million.
India, Indonesia and Nigeria accounted for almost half of this global
-Only one in five
MDR-TB cases were started on treatment. India and China accounted for
39% of the global gap. Treatment success remains low, at 54% globally.
-Of the almost
half a million reported cases of HIV-associated TB, 15% were not on
antiretroviral therapy (ART) as recommended by WHO. Most of the gaps
related to HIV-associated TB were in the WHO African Region.
treatment is expanding in two priority risk groups - people living with
HIV and children under 5 years. However, most people eligible for TB
preventive treatment are not accessing it.
-For TB care and
prevention, investments in low- and middle-income countries fall almost
US$ 2.3 billion short of the US$ 9.2 billion needed in 2017. In
addition, at least an extra US$ 1.2 billion per year is required to
accelerate the development of new vaccines, diagnostics, and medicines.
"Shortfalls in TB
funding are one of the main reasons why progress is not fast enough to
be on track to reach the end TB targets," said Dr Katherine Floyd,
Coordinator of WHO?s Monitoring and Evaluation Unit at the
Global TB Programme. "We have a double challenge. More domestic funding
is needed in middle-income countries, and more international donor
support is needed to support low-income countries".
commitment and multisectoral action
Ending the TB
epidemic requires action beyond the health sector to address the risk
factors and determinants of the disease. For the first time the Global
TB Report presents results from a new multisectoral monitoring
framework that identifies linkages with the TB epidemic across seven
Sustainable Development Goals (SDGs). Analysis of the latest status of
the indicators for the 30 high TB burden countries show that most will
be challenged to reach SDG targets.
In order to
increase multisectoral action, plans to galvanize all sectors and
secure attention at the highest levels have resulted in the WHO Global
Ministerial Conference on Ending TB in the Sustainable Development Era,
in Moscow, 16?17 November 2017. This will be followed by the
very first UN General Assembly High-Level Meeting on TB in 2018, which
will seek commitment from heads of state.
Conference on Ending TB
(1) The ten
countries were: India, Indonesia, Nigeria, the Philippines, South
Africa, Pakistan, Bangladesh, the Democratic Republic of the Congo,
China and the United Republic of Tanzania.
Articel By : Prof.
dr. Tjandra Yoga Aditama, SpP(K), MARS, DTM&H, DTCE
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