Today is World Tuberculosis (TB) Day. It is a day when the whole world is reminded of the menace that TB continues to exert on human populations despite the existence of effective control interventions. The theme for this year’s World TB Day is “Innovation”. The slogan is “On the move against tuberculosis”.
TB remains a communicable disease of major public health concern in the African Region. Africa, with approximately 12% of the world population, disproportionately accounts for at least 22% of new TB cases every year. The African Region has the highest TB notification rate per 100 000 population. In the Region, only about 47% of estimated new TB cases in the population are identified and, of these, only 79% complete their treatment. In 2008, only 12 countries in the Region reached the internationally-recommended target of identification of at least 70% of estimated new cases while 13 countries attained the internationally-recommended treatment completion target of 85%.
On average, 35% of all TB patients in the Region are also infected with HIV. This dual infection makes TB one of the highest killers of adults living with HIV, with estimates nearing about 40% of all deaths in HIV-infected adults. The spread of TB has been complicated by the emergence of drug-resistant strains, known as Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB). TB cases caused by drug-resistant strains are difficult to treat. Although the true burden of drug-resistant TB is not known, cases have been identified in all countries where surveys have been undertaken. To date, 33 countries in the Region have reported at least one case of MDR-TB and eight of them have reported at least one case of XDR-TB.
A major impediment to accelerated scale up of control activities is the weakness of health systems in countries in our Region. Government funding for TB control activities is generally inadequate; quality-assured TB laboratory networks are scarce, thus limiting access to diagnostic capacity; trained personnel to deliver quality TB services are in limited numbers; recording and reporting systems for monitoring disease trends and assessing the impact of interventions and financial flows are weak.
The theme and the slogan of World TB Day 2010 respond directly to the need to accelerate our efforts towards greater community involvement and increased research with a view to ensuring better and more accurate diagnostic methods and access to treatment, including treatment of drug-resistant cases.
To this end, WHO and partners are supporting research for the development of new diagnostic tools and medicines to speed up case identification and shorten the duration of treatment.
I would like to use this occasion to call on national authorities to mobilize additional resources for TB control from government, the private sector and other partners. This could be facilitated through the establishment of national Stop TB Partnerships.
Governments, nongovernmental organisations, community-based organisations, prison and military services, and other partners should all collaborate to ensure uninterrupted availability of quality-assured first and second line anti-TB medicines. They should also facilitate testing of all TB patients for HIV and linking of all HIV co-infected patients to HIV/AIDS care services especially for antiretroviral treatment and co-trimoxazole preventive treatment in line with WHO guidelines. It is also essential for all countries to establish and scale up management of drug-resistant TB as part of basic TB control programme activities. All HIV care providers should facilitate screening of their patients for TB to ensure that those who are infected receive the benefit of early diagnosis and treatment.
National authorities and all health care providers should engage communities and civil society to enable them to refer people with symptoms of TB for examination and also to supervise patients on treatment, increase treatment adherence, reduce the number of patients who do not complete treatment and, ultimately, reduce death rates through timely diagnosis and quality treatment. The general public should also take responsibility for reporting at a health facility for examination and treatment when they develop cough or are otherwise unwell.
With only five years to go before the MDG target year, these and many other actions are urgently needed to ensure progress in TB control in the African Region. National governments and collaborating partners should join hands in the renewed fight against TB in our Region.
I am convinced that, together, we can make a big difference and that, through our collective efforts, TB will cease to be a public health problem in Africa.
Together, let us all use greater Innovation to move against TB this year.