I applaud the World Health Organization (WHO) today on the release of the Global Tuberculosis Report 2013, which includes among its recommendations, a call to action to reach millions of people still awaiting quality tuberculosis (TB) care and a stronger approach to fighting the emerging threat of multidrug-resistant TB.
While this year’s report is an important reminder that TB continues to claim millions of lives globally, it also demonstrates that significant progress in preventing, detecting, and curing people of the world’s second biggest infectious killer can be made through strong political will, adequate resources, and a focus on the poorest and most vulnerable communities around the world.
On the positive, we are seeing a steady decline in TB mortality rates since 1990, bringing us closer to the UN Millennium Development Goal to halve TB prevalence and deaths by 2015, with fewer people now falling ill from the disease. However, as the report warns, large numbers of individuals with TB still remain undetected and untreated, and hard to treat multidrug-resistant (MDR) TB is now on the rise.
The WHO recommendations are based on new data from almost 200 countries and territories around the world. The report includes the most recent numbers on people who became sick or died from TB, MDR-TB and TB/HIV, as well as lives saved, treatment successes and gaps, and recent progress in roll-out of new TB diagnostics.
Out of the five priority actions recommend in the report, I would like to highlight two key challenges in particular. First, we should make every effort to reach the 3 million people a year (“missed” patients as the report calls them) who get ill with TB but don’t receive the quality care they urgently need. Many of these people are among the most vulnerable and stigmatized, often at the bottom of the social spectrum. Universal health coverage and poverty alleviation are critical for bridging this gap and providing better access and quality TB services to those at risk.
Second, the global health community must have a strong plan of attack for addressing the alarming increase in MDR-TB. Data in the WHO report show that progress towards targets for diagnosis and treatment of MDR-TB is far off-track. Worldwide, and in most countries with a high burden of MDR-TB, less than 25% of the people estimated to have MDR-TB were detected in 2012. MDR-TB is not only a tragedy for the patient, the effects can be disastrous, as an entire community can become infected with the drug-resistant organisms.
USAID is leading the charge in both of these areas by expanding access and quality of TB services including further prevention of the disease through interventions such as contact tracing and infection control. We are also collaborating with countries and partners to introduce and scale-up MDR-TB programs in countries with the highest burden. If successful, The USAID-funded STREAM study will be a significant win in the fight against MDR-TB. This innovative study will not only reduce the treatment regimen for MDR-TB from the current 20+ months to 9 months, it will also result in considerable cost savings to the health care system and in alleviating suffering by the patient. Until then, we must optimize DOTS programs and improve infection control to prevent the creation and transmission of MDR-TB.
The United States has a strong record of success in partnering with local governments, civil societies and the private sector to harness the power of science, technology and innovation to deliver health better, more effectively, and at lower cost. Rapid acceptance of new tools, through technology transfer, and support for path breaking research will be essential in ensuring that at-risk communities can benefit from new innovations in our fight against TB.
The U.S. Government remains a major contributor to the Global Fund to Fight AIDS, TB, and Malaria, a unique partnership of governments, the private sector, civil society and affected communities joined together, unanimous in their desire to fight TB. Many low-income countries rely heavily on international donor funding, with the Global Fund providing around 75% of these financial resources. We need to ensure continued leadership in financing for high burden TB programs while advocating for increases in domestic resources to close the resource gaps, estimated at about US $2 billion per year. Commitment from the international community is crucial for addressing this funding gap.
Investing in global health is not only the smart thing to do – it is the right thing to do. We stand together with WHO and our international partners to save lives from TB and other diseases, and to develop healthier societies in the countries with the most need. We are also pleased to support the documentation and analysis of trends in diagnosis, treatment, and outcome. These data are essential to informing national programs and donor strategies.
I congratulate WHO, our other global partners, and the governments of high burden countries around the world for their leadership in global TB control and look forward to continued progress in this area.
Learn more about USAID’s tuberculosis programs.
Get details on the 2013 WHO Global Tuberculosis Report.