Message of the Regional Director , Dr Luis G. Sambo, on occasion of World Tuberculosis Day, 24 March 2007

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Today 24 March, is World TB Day. It is a day for all to pause and reflect on the continuing public health importance of a curable disease that continues to cause suffering and death to thousands of people in our Region. The day reminds us of the historical day in 1886 when Robert Koch announced the discovery of the causative organism for Tuberculosis, effectively opening possibilities for its treatment and cure. Indeed effective treatment for TB exists and is widely even in our region. Many people are accessing TB treatment and coverage with DOTS based TB control services has continued to increase in countries.

Despite good progress with implementing the DOTS Strategy, notified TB cases have continued to rise in many countries in our Region, especially where TB/HIV co-infection rates are high. Access to diagnostic and treatment services is not yet universal and the quality of available services remains low. Furthermore, it is estimated that only half of existing TB cases are being identified and put on treatment. Of those put on treatment, less than 75% are being successfully cured mainly due to unacceptably high proportion of TB patients lost to follow up within the national programme.

Where HIV prevalence is high, TB incidence has increased several fold, making TB/HIV co-infection the main epidemiologic factor driving the TB epidemic in the region. On average, 35% of TB patients in the region are co-infected with HIV. In some areas in Southern and East Africa, over 50% of TB patients are co-infected with HIV and at least 40% of AIDS deaths are due to TB.

Recognizing the gravity of the situation, Ministers of Health of the African Region adopted a Resolution in August 2005 calling upon Member states to declare TB a public health emergency and to accelerate the fight against the epidemic. Notwithstanding, during the past year, TB cases resistant to first and second line anti TB drugs (Extensively Drug Resistant TB (XDR-TB)) have been reported in some countries in the region, underlining further the public health urgency of the TB situation in the Region.

The theme for this year’s World TB Day, “TB Anywhere is TB Everywhere” emphasizes the tragedy the above situation represents. TB is infectious and everyone everywhere is potentially at risk of infection. The theme also underlines the collective responsibility we all have as individuals, member states, and part of the world community to bring TB under control.

Member states in collaboration with the international community must therefore take urgent action to accelerate scaling up of quality DOTS services, increase the low TB case detection and treatment success rates, and scale up TB/HIV interventions in the Region. Member states must also take urgent action to identify, quantify and effectively treat drug resistant TB cases in order to stop transmission.

More importantly, national programmes must ensure that all uncomplicated TB cases are successfully treated in order to prevent emergence of drug resistant strains. The main cause of drug resistant TB is poor initial patient management including wrong or inadequate treatment regimens. High patient default rates as observed in many countries in the region exacerbate this likelihood. In today’s global village, drug resistant TB cases anywhere are drug resistant TB cases everywhere.

I therefore call upon political leadership in all member states to dedicate adequate resources to the fight against TB and to champion the call to attain universal access to high quality TB services. This is consistent with declaration of TB as an emergency by the Regional Committee in August 2005 and the call by Heads of State and Government for Universal Access to AIDS, TB and Malaria (ATM) services by 2010.

I further call upon the international community to demonstrate continuing solidarity with us in the fight against TB in the region as one way to control TB everywhere in the world.

The regional office will continue to collaborate with regional partners and regional economic communities to provide technical support to countries to promote implementation of effective TB control programmes capable of reducing suffering and death towards the Millennium Development Goal targets.

In order to give effective meaning to the World TB Day theme for this year, everyone everywhere in the region must make a special effort to contribute to the identification and or successful treatment of an existing TB case in their locality. Remember, TB like all other communicable diseases does not respect borders or persons. Everyone is at risk until transmission is halted and everyone has a role to play to bring this about.

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