WHO Global Tuberculosis Report 2013

October 25, 2013
by David Bryden

A major report on tuberculosis was released this week by the World Health Organization, and it gives us new information we can use to persuade policy makers to act to stop this disease, which pushes people into poverty and causes enormous suffering and fear.  Untreated, the airborne and infectious disease is fatal.

As with all such reports, the key thing is to focus on the real people behind the mind-numbing statistics.  Read a story from a patient and THEN read about the report.   Try this one, in which a South African patient describes her MDR TB (multi-drug resistant TB) treatment as being, “ASSAULTED by the world’s most painful injection that burned as it entered my body and caused my bottom to sting painfully as it went in.”

Just a few years ago, 31 children in California became infected with MDR TB after an elementary schoolteacher developed the disease.  Many were unable to complete the preventive therapy because of the severe side effects.

The report issues a clear call to action on drug resistant TB, which it calls a “public health crisis.”  WHO estimates that 450,000 people fell ill with MDR-TB in 2012 alone, and at least 16,000 MDR-TB cases reported to WHO in 2012 were not put on treatment, with long waiting lists developing.   For instance, in “We are sitting and watching a ticking bomb,” said Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership, in response to the report.  Considering all forms of TB, an estimated 3 million cases are being “missed” every year by health systems, new cases of TB are falling only 2% a year, and Africa and Europe are not on track to reach the Millennium Development Goal on TB by 2015. 

In some countries the TB problem is much worse than shown by the current official statistics.  Take Nigeria for example, by far the most populous country in Africa.  It was thought that the country was finding about half of the TB cases, but a recent, more detailed survey shows that in fact only about 20% of cases are being found and prevalence of TB is many times what had previously been estimated. 

I met the energetic director of Nigeria’s TB program, Dr. Joshua Obasanya, at a meeting in Washington recently, and he told me that Nigeria is using the survey results to develop a new Strategic Plan for TB in Nigeria.  He said, “We need to get the strategy right; this is the time for all ‘hands to be on deck.’”

The WHO report calls the Global Fund “absolutely essential” in the fight to end TB, and so urging increased support for the Fund is a crucial way we can help Nigeria, Myanmar and many other countries.  The U.S. must commit its fair share by pledging $5 billion to the Global Fund over the next three years

TB advocates are also working to increase the support of the Obama Administration for USAID’s TB program, which is helping to fund surveys like the one in Nigeria as well as to develop much easier-to-take TB medication.  A letter from 65 tuberculosis experts in the US to President Obama was sent this week, urging  to refrain from reducing the TB program’s funding again in his FY 15 budget proposal (in his FY 14 proposal he requested a 19% cut).  Since children’s health is a priority for President Obama perhapsa recent, groundbreaking report from Uganda, might be persuasive too, since it shows many children suffering from pneumonia also have pulmonary TB.

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