[india-drug] WHO sees surge in progress against tuberculosis on eve of

[Sunitha.Srinivas.s.srinivas@ru.ac.za]

global summit
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(http://www.who.int/tb/publications/global_report/2004/en/India.pdf
provides the information regarding the situation of TB in India)

(Source: http://www.who.int/mediacentre/releases/2004/pr20/en/
Thanks?SS)


WHO sees surge in progress against tuberculosis on eve of global summit
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Health, finance ministers meet in New Delhi on challenge of treating an
additional one million patients a year
23 MARCH 2004 | GENEVA/NEW DELHI -- The number of tuberculosis patients
diagnosed and treated under DOTS*, the internationally recommended
strategy for TB control, is now rising much faster than at any time
since DOTS expansion began in 1995, according to a new report by the
World Health Organization (WHO). Indeed, the past two years have
witnessed accelerated growth in the implementation of DOTS programmes
worldwide.

The 2004 Global Tuberculosis Control report confirms that DOTS
programmes are now treating three million TB patients every year, an
increase of more than one million patients compared to just two years
ago. That increase is nearly double the average annual increment of
270,000 patients during the previous six-year period, and the
trajectory is still heading upward. India is leading the surge with
more than a quarter of all additional DOTS cases being treated,
followed by smaller but significant increases in five other key
countries with high rates of TB: South Africa, Indonesia, Pakistan,
Bangladesh and the Philippines.

The findings of the report will be presented Wednesday by LEE
Jong-wook, WHO Director-General, at the opening session of the 2nd Stop
TB Partners' Forum in New Delhi, a two-yearly summit of donors,
technical agencies, NGOs and ministers from the 22 high-TB burden
countries under the umbrella of the global Stop TB Partnership.

"DOTS expansion is one of the major public health success stories of
the past decade, one that is saving thousands more lives every day," Dr
Lee said. "But to reach the 2005 targets for detection and treatment,
the challenge now is to add another one million TB patients to DOTS
programmes each year. Many of these new cases will be recruited from
the hospitals and private health sector in Asia, especially China, and
from beyond the present limits of health systems in Africa."
The global 2005 targets for TB control are to detect 70% of all
infectious TB cases and cure 85% of those cases detected. According to
the WHO report, the case detection rate has risen to 37% and cure rates
to 82%. Meeting the 2005 targets will put the world's TB control
programmes on the path to achieving the Millennium Development Goal
(MDG) of halving the global TB burden by 2015.
Expanding and strengthening DOTS is key to halting the spread of TB
because it is cost-effective, ensures treatment compliance, and
prevents the development of drug-resistant strains of TB. Of the 210
countries that reported TB case notifications and/or treatment outcomes
to WHO in 2002, 180 are today implementing the DOTS strategy and
providing access to services for nearly 70% of the world's population.
The World Bank, a key member of the Stop TB Partnership and a leading
financier of TB-related programmes in developing countries, welcomed
the WHO report as evidence that donor funding for expanding DOTS
treatment had proven effective in improving the health and welfare of
communities afflicted by the disease. "This new evidence is important.
Speeding up TB case detection is the critical first step in curing more
patients and driving down disease," said James Wolfensohn, President of
the World Bank. "This gives us solid ground to push for the greater
support needed to reach our goals faster. Strengthening overall health
systems to reach the poor will be another critical route towards
controlling TB."
There are an estimated 8.8 million new cases of TB each year of which
3.9 million are infectious. The number of new cases is increasing
rapidly in Eastern Europe, mainly countries of the former Soviet Union
which only recently started to implement DOTS. A special surveillance
report issued last week by WHO found that TB patients in parts of
Eastern Europe and Central Asia are 10 times more likely to have
multidrug-resistant TB than in the rest of the world. TB incidence
rates also continue to rise at an alarming rate in African countries
with high HIV prevalence.
"HIV/AIDS is driving the TB epidemic in southern and eastern Africa and
will worsen the situation in Eastern Europe, India and China in the
years ahead," said Dr Jack Chow, the WHO Assistant Director-General for
HIV/AIDS, Tuberculosis and Malaria. "We cannot control one without
controlling the other, and must begin rapidly scaling up TB/HIV
collaborative activities to provide a synergy of prevention, treatment
and care for co-infected patients."

Another key document to be presented at the Delhi summit will be a
progress report on the Global Plan to Stop TB, the strategic roadmap
which guides the development and work of the Stop TB Partnership. The
report assesses progress in 8 key areas: DOTS expansion; DOTS-Plus for
Multidrug-Resistant (MDR) TB; TB/HIV, research and development for new
TB drugs, diagnostics and vaccines; the Global TB Drug Facility; and
resource mobilization. "The Global Plan covers the five-year period
from 2001-2005, and this progress report will tell us how well we are
doing in meeting the process targets of the Plan at the midway point,"
said Ernest Lowensohn, chairman of the Stop TB Coordinating Board.
The DOTS strategy comprises five main elements: 1) political
commitment, 2) diagnosis of TB patients through sputum microscopy, 3)
directly observed treatment of patients taking their anti-TB drugs, 4)
access to adequate supplies of quality drugs, and 5) monitoring and
accountability for every patient diagnosed.


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