TBDay.pngAhead of the World TB Day–observed on 24 March Ã¢ÂÂ the WHO has called upon countries and partners to “”Unite to End Tuberculosis””. The call comes as the world enters the era of the Sustainable Development Goals (SDGs). Ending tuberculosis (TB) by 2030 is a target of the SDGs and the goal of the WHO End TB Strategy. Describing it as an ambitious aim, the WHO has said in a statement that while there has been significant progress in the fight against TB, with 43 million lives saved since 2000, the battle is only half-won: over 4Ã 000 people lose their lives each day to this leading infectious disease. Many of the communities that are most burdened by tuberculosis are those that are poor, vulnerable and marginalized.
“”Ending TB will only be achieved with greater collaboration within and across governments, and with partners from civil society, communities, researchers, the private sector and development agencies. This means taking a whole-of-society and multidisciplinary approach, in the context of universal health coverage,”” the statement says. Momentum is growing at country and community levels Ã¢ÂÂ including in the 30 countries with the highest TB burden (over 85% of the global burden). A number of countries are strengthening the strategic agendas of their TB programmes, by adopting newer tools, extending access to care and linking with other parts of government to reduce the financial costs borne by patients. Other countries are partnering with researchers to speed development of diagnostic tests, drugs and vaccines, and to improve delivery.
Citing IndiaÃ¢ÂÂs progress, the statement says that it is home to more people ill with TB and multidrug-resistant TB (MDR-TB) than any other country, and has committed to achieving universal access to TB care with its campaign for a TB-Free India.Ã The Ministry of Health and Family Welfare is expanding its capacity to test patients rapidly for drug-resistant TB and is initiating use of bedaquiline, a new, WHO-recommended drug in MDR-TB treatment. In addition, by making TB case notification mandatory in 2012 and by intensifying efforts to engage the private sector, case notifications rose 29% in 2014 alone. In working towards universal health coverage, South Africa has greatly expanded access to Xpert MTB/RIF, a WHO-recommended rapid molecular test for TB and drug-resistant TB. South Africa has the largest number of people living with HIV who are receiving TB preventive treatment in the world. Similarly, the statement also cites the achievements made in Thailand, the Russian Federation, Brazil and Vietnam in dealing with TB at various levels.
However, despite these advances, the WHO points out that formidable challenges remain including fragile health systems, human resource and financial constraints, and the serious co-epidemics with HIV, diabetes, and tobacco use. MDR-TB is another critical challenge. Urgent and effective action to address antimicrobial resistance is key to ending TB by 2030. So are increased investments, as the global tuberculosis response remains underfunded for both implementation and research. TB ranks alongside HIV/AIDS the worldÃ¢ÂÂs top infectious disease killer with 9.6 million falling ill in 2014 and 1.5 million dying from the disease including 3.8 lakh among those living with HIV. More than 95% of TB deaths occur in low- and middle-income countries, and TB is among the top 5 causes of death for women aged 15 to 44.
Even worse, in 2014, an estimated 1 million children became ill with TB and 140,000 children died. Globally, in 2014, an estimated 480,000 people developed MDR-TB. The WHO End TB Strategy aims to reduce TB deaths by 90% and to cut new cases by 80% between 2015 and 2030, and to ensure that no TB-affected family faces catastrophic costs due to TB. India has the highest TB burden in the world. According to the WHO Global TB Report 2015, of the estimated global incidence of 9.6 million TB cases, 2.2 million were estimated to have occurred in India though there have been remarkable achievements in combating the disease since 1990.
“”Despite the highly acclaimed Revised National Tuberculosis Control Programme (RNTCP) and other initiatives of the government, there is no respite from this disease and we continue to lose thousands of valuable liver every day because of TB notwithstanding the valuable loss of human capital and huge economic burden of nearly 24 billion dollars annually,”” points out Dalbir Singh, president of Global Coalition Against TB. According to Mr Singh, since nearly 60 % of patients are still treated in the highly unregulated private sector, it is imperative that we engage it productively and proactively with a rational structure so as to prevent spread of Multi Drug Resistant TB, caused largely by inappropriate treatment regimens used in the private sector.
“”The shortfalls in the budget allocated for TB in the public sector must also be addressed on priority. If we have to eradicate this epidemic in the timeframe set in our strategic plan, we have to display enormous political will, step up our research and development efforts possible by establishing a ‘National TB Research Consortium’ and make effective use of tools like ICT, create partnerships and learn from best experiences of other countries in addition to sensitizing policymakers at all levels,”” he says.”