The new data published in the WHO Global Tuberculosis Report 2012 show clear signs of progress. Despite signs of progress at the global level, the new WHO report shows that TB continues to have a stranglehold on Africa, especially among women living with HIV and AIDS.
TB care has saved 20 million lives in the past 17 years, the number of people getting sick with TB has fallen 2.2% since last year and a rapid diagnostic test is now available in 67 low- and middle-income countries.
Looking forward, there are urgent and significant challenges that we must focus on in the next three years.
The report confirms that HIV is driving the TB epidemic in Africa and that 75% of the HIV-positive people who died from TB in 2011 lived in Africa. In addition, it reveals that the region’s HIV-associated TB now disproportionately affects women. More HIV-positive women than men died from TB in Africa in 2011.
Along with Europe, Africa is the only region that is not on track to reach the MDG-related target of halving the TB death rate by 2015, compared to 1990.
The African TB death rate among HIV-negative people has been falling gradually since 1990, but the number of HIV-negative people dying from TB in Africa has actually increased from 200 000 in 1990 to 220 000 in 2011.
The total number of people dying from TB in Africa was 548 000 in 2011. Of these, 220 000 were among HIV-negative people and 328 000 were among HIV-positive people. This represents almost 40% of the global total and reveals that Africa has more TB deaths than any other region.
Without an accelerated response, up to 1.8 million Africans will die from TB by the end of 2015.
The report reveals that we have collectively failed to make progress on detecting and treating people with TB. In 2011, only 5.8 million people were notified to national TB programmes and received treatment consistent with international guidelines.
This is just 66% of the estimated total number of cases and leaves around 3 million people who either received no diagnosis and treatment or got potentially substandard treatment. Sadly, this figure has not changed for the past three years.
What to do? It is fast becoming clear that prioritized actions in Africa are needed.
Our overriding concern should be the lack of adequate financing for TB care and research and development. The numbers speak for themselves.
We need US$ 8 billion dollars per year to meet the implementation targets of the Global Plan to Stop TB. In 2011, national budgets for TB covered US$ 4.3 billion.
External donors provided US$ 480 million, of which US$ 440 million came from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Africa’s outlook is especially worrying. Only about 6% of Global Fund funds disbursed in Africa were for TB care–a fraction of what is needed.
This leaves us with a gap of US $3 billion a year.
On the research front, there was a 70% funding gap. Only $600 million was available for the development of desperately needed new diagnostic tools, drugs and vaccines against a total annual need of US $2 billon.
Africa Science News