Today, on World TB Day, the World Health Organization in the Western Pacific Region reiterates the need for governments, policy-makers, health care providers and civil society organisations to prioritise interventions to urgently find, treat and cure the millions of people who remain undiagnosed with the disease.
Globally, of the estimated nine million people a year who develop tuberculosis (TB), some 30 per cent – three million – are “missed”, meaning they are not found, treated and reported to national health authorities. In the Western Pacific Region, an estimated one in five TB cases are missed.
Cambodia, China, the Philippines and Vietnam account for 93 per cent of the estimated regional TB burden of 1.6 million cases and 110,000 deaths each year.
These four countries are among the 22 high-burden countries worldwide.
“We must ensure that we can identify every single case of TB, as many individuals with TB remain undiagnosed and untreated,” advised Dr Shin Young-soo, WHO Regional Director for the Western Pacific.
“Universal access to TB treatment and care must include not only standardised effective treatment, but also adequately trained health care providers who will help in successfully finding, treating and curing every patient.”
“A significant challenge in the region is that there are too many people with TB who remain undiagnosed in the community,” noted Dr Nobuyuki Nishikiori, Team Leader, Stop TB and Leprosy Elimination, WHO Regional Office for the Western Pacific.
“The majority of these cases are people who live in some of the poorest and most vulnerable communities, or are among marginalised populations such as migrants, prisoners and ethnic minorities.
Ensuring TB services for children and the elderly is also a challenge due to difficulties in diagnosis and treatment.”
Apart from the high number of missed TB cases, another challenge in the region is the threat of drug-resistant TB, with an estimated 75,000 multi drug-resistant TB (MDR-TB) patients added annually and increasing numbers of patients with extensively drug-resistant (XDR) TB.
WHO analysis shows that the majority of MDR-TB is in newly diagnosed TB patients, meaning people are being infected by resistant strains. This is in addition to patients developing resistance only during their treatment.
“Although TB treatment itself is free from government health services, on average half of all patients experience a catastrophic financial burden,” Dr Nishikiori said.
“There are significant medical expenses besides the drugs.
“Many patients must travel long distances to access clinics and medication, so their transportation costs are high. Then there’s lost income when they can’t work for long periods of time.
“And sadly, many TB patients still experience significant stigma as they often lose their social support and employment, often rejected by family and shamed for their condition.”
To meet these challenges, the WHO through extensive consultation with member states and international partners, has developed a new global strategy that was recommended for consideration and adoption by the 67th World Health Assembly which meets this coming May.
The vision for this TB strategy is “a world free of TB”, also expressed as “zero deaths, disease and suffering due to TB”.
“TB control today is in a dynamic stage of transformation, with new diagnostics, drugs and even vaccines in the pipeline,” concluded Dr Shin.
“Building on the huge successes we have made, and with these new tools and global strategy, I’m confident we can overcome these challenges and provide a safer world for our children, increase social equity and eliminate this disease, which continues to cause far too much suffering for far too many people in the region and around the world.”
• Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent.
• In 2012, 8.6 million people fell ill with TB and 1.3 million died from TB.
• More than 95 per cent of TB deaths occur in low- and middle-income countries, and it is among the top three causes of death for women aged 15 to 44.
• In 2012, an estimated 530,000 children became ill with TB and 74,000 HIV-negative children died of TB.
• TB is a leading killer of people living with HIV, causing one fifth of all deaths.
• Multi-drug resistant TB (MDR-TB) is present in virtually all countries surveyed.
• The estimated number of people falling ill with tuberculosis each year is declining, although very slowly, which means that the world is on track to achieve the Millennium Development Goal to reverse the spread of TB by 2015.
• The TB death rate dropped by 45 per cent between 1990 and 2012.
• An estimated 22 million lives were saved through use of DOTS and the Stop TB Strategy recommended by the WHO.
World Health Organization