Beating back TB, slowly but surely

ABOUT 36million people have been cured of tuberculosis over the past 15 years through a rigorous approach to treatment, according to the World Health Organisation.

ABOUT 36million people have been cured of tuberculosis over the past 15 years through a rigorous approach to treatment, according to the World Health Organisation.

But last year 1,8million people died from TB - including half a million deaths associated with HIV - many of them because they did not have access to antiretrovirals.

New data, released in Washington by WHO, also indicated that up to 8million TB deaths have also been averted. The organisation claimed these figures confirmed that DOTS - its stop TB strategy - as the most cost-effective approach in the fight against tuberculosis.

DOTS was first developed in 1994 and was later incorporated into WHO's stop TB strategy as its main component.

It has five elements: political commitment with increased financing, case detection through quality-assured bacteriology, standardised treatment with supervision and patient support, an effective drug supply and management system, monitoring and evaluation system and impact management.

Since the launch of DOTS, the number of people being cured has increased regularly, the WHO said. Data from the latest 12-month period now show that the highest ever number of infectious patients - 2,3million people - were cured. With 87percent of treated patients being cured, the 85percent global target was exceeded for the first time since it was established in 1991. A total of 53 countries surpassed this treatment milestone.

The WHO update shows continued progress on addressing the lethal combination of TB and HIV. Between 2007 and 2008, 1,4million TB patients were tested for HIV, an increase of 200000. Of those who tested HIV-positive, one-third benefited from life-saving HIV anti-retroviral therapy and two-thirds were enrolled on co-trimoxazole prophylaxis to prevent the risk of fatal bacterial infections.

In addition, screening for tuberculosis and access to isoniazid preventive therapy for TB among people living with HIV more than doubled, although the total number is still far short of what it should be.

"Fifteen years of TB investments are bringing visible results in terms of human lives saved. Together, national programmes, WHO, UNAIDS, the Global Fund and other partners have helped save millions of lives from TB," said Dr Mario Raviglione, director of WHO's stop TB department. "But the current pace of progress is far from sufficient to decisively target our goal of TB elimination."

TB remains second only to HIV-Aids in terms of the number of people it kills. In 2008, 1,8million people died from TB - including half a million deaths associated with HIV - many of them because they were not enrolled on antiretroviral therapy.

"Without help to fill the $2billion (R15billion) funding gap for TB care in 2010, the most vulnerable people will continue to miss the benefits so many others have seen," Raviglione said. - Health-e News

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