Africa: TB Deaths Reach New Lows, World Health Organization Says

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Photo: Gary Hampton/World Lung Foundation
The current method of TB testing relies on labour-intensive microscopy.

Washington — The number of deaths from tuberculosis and the number of new cases of this infectious disease are both on the decline, according to data released by the World Health Organization (WHO) October 11.

The number of TB deaths is moving steadily downward from 1.8 million in 2003 to 1.4 million in 2010. The number of people who fell ill came down from 9 million in 2005 to 8.8 million in 2010, WHO reported.

"In many countries, strong leadership and domestic financing, with robust donor support, has started to make a real difference in the fight against TB," said WHO Director-General Dr. Margaret Chan. "The challenge now is to build on that commitment to increase the global effort."

The United States has been among the donor nations that have helped to bring about the progress against this disease, which has plagued humankind since the dawn of history. On the occasion of World Tuberculosis Day last March, Secretary of State Hillary Rodham Clinton said the United States will sustain its commitment to combat the disease.

"In collaboration with existing TB programs and our partners throughout the world, the United States is uncovering new knowledge on prevention and treatment strategies; upgrading laboratory infrastructures; training the next generation of researchers and health care providers; and introducing new diagnostic and treatment tools," Clinton said.

Health policymakers devoted new energies and resources to tuberculosis in the last decade when it was recognized as a principal cause of death for people with AIDS. Resources and partnerships devoted to quelling AIDS have also bolstered the campaign against TB, including the Global Fund to Fight AIDS, Tuberculosis and Malaria; the President's Emergency Plan for AIDS Relief (PEPFAR) enacted under the administration of George W. Bush; and now the Obama administration's Global Health Initiative.

The U.S. Agency for International Development (USAID) works to contain and treat TB with $225 million earmarked for those efforts in 2010 and an anticipated $230 million in 2011.

"USAID is proud to support the critical work of domestic and international partners against TB," said Ariel Pablos-Mendez, assistant administrator for USAID's global health programs, at a Washington news conference unveiling the new WHO report. "We know that treating TB abroad saves lives while also saving money here at home."

The international aid community hums with concern these days about whether its activities will undergo serious funding cuts due to the strain on government budgets in the United States and many other donor nations. Pablos-Mendez urged against cuts that might undermine efforts to improve global health.

"We know from past experience that continued vigilance is essential to maintaining gains and reaching our goals; failing to do so is likely to result in major outbreaks of drug-resistant TB, such as those seen in the United States in the late 1980s, the former Soviet republics in the early 1990s and Africa more recently," Pablos-Mendez said.

Advances in technology are also cause for improvement in TB survival. New diagnostic methods can identify the disease in rural areas without the need for a sophisticated laboratory and technicians to process and analyze tissue samples. There are also new treatments coming into use that simplify what has been a long and sometimes uncomfortable drug regimen lasting up to six months.

These advances are important, but they are also balanced against the need for progress in the identification and treatment of multidrug-resistant TB (MDR-TB). Patient failure to properly complete the full six-month drug treatment has led to the emergence of a more deadly strain of the TB pathogen that does not respond to the usual drugs, and requires a more complicated and more expensive drug treatment.

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