Global plan to stop tuberculosis: investment in TB control works but progress uneven.

• Position: HEALTHWATCH

Three of the world's six regions are expected to achieve targets for tuberculosis (TB) control, according to a World Health Organization (WHO) report published on 22 March 2006.

The Americas, South-East Asia and the Western Pacific regions should reach targets set by the World Health Assembly to detect 70 per cent of TB cases and successfully treat 85 per cent of these cases by the end of 2005, according to the Global Tuberculosis Control 2006. The report confirms that 26 countries had already met the targets a year ahead of time, two of them being the high-TB burden countries of the Philippines and Viet Nam. It also indicates that five other high-burden countries--Cambodia, China, India, Indonesia and Myanmar--should have reached the targets within the 2005 time frame, though final confirmation will come at the end of 2006.

WHO Director-General Dr. Lee Jong-wook said: "There is clear evidence that investment in TB control works. Even in low-income countries with enormous financial constraints, programmes are operating effectively and producing results. This same commitment needs to be replicated in African countries and other areas where funding and priority for TB control remains fragile."

The latest estimates in the report suggest that 1.7 million people died from TB in 2004 and there were also 8.9 million new cases, with its number per capita rising at 1 per cent per year globally as a consequence of the TB crisis in Africa--a crisis attributed partly to the complications of HIV infection and poor health systems. Eastern Europe, with its high prevalence of multi-drug-resistant tuberculosis (MDR-TB), also continues to have an adverse impact on the global treatment success rates.

Despite the cost-effectiveness of TB control, there is concern that African leaders are still failing to seriously invest in it. Response to the 2005 TB emergency declaration in Africa has been, for the most part, far too sluggish. The report highlights the need for a much more rapid and vigorous response to the African TB emergency, including more ambitious plans that are backed up by more...