Harare, 4 April 2003 -- Treatment success and case detection rates for tuberculosis (TB) have improved appreciably in Africa since 1993 when the disease was declared a global emergency by the World Health Organization (WHO), but the current indicators in the Region still fall short of global targets, a WHO official has said in Harare, Zimbabwe. 
In a presentation at a seminar to mark this year's World TB Day, the WHO Adviser for TB in the African Region, Dr Eugene Nyarko, stated that in the last decade, treatment success and case detection rates of infectious forms of lung TB in the Region had increased from 59% to 70%, and from 32% to 52% respectively, between 1995 and 2000.

Dr Nyarko also indicated that the case notification rate for TB had increased phenomenally by more than 95% over the same period, from 83 per 100,000 population about ten years ago, to 164 per 100,00 population in 2001.

He added that the number of countries in the Region implementing the WHO-recommended Directly Observed Treatment-Short Course (DOTS) strategy for TB control had also increased from 17 countries in 1993 to 41 in 2002. This translates into 68 % of the Region's population having geographic access to DOTS services.

"These are all encouraging statistics, although some of the figures still fall short of the global targets. For example, the overall treatment success rate for infectious forms of lung of 70% falls short of the global target of 85%, while the current case detection rate of 52% falls short of the global target of 70% ", he said.

Dr Nyarko told participants at the seminar that countries in the Region faced five key challenges in boosting TB control efforts in the years ahead. These are: involving communities and private sector partners in scaling up DOTS services, harnessing local capacity for effective delivery of DOTS services; effective decentralization of programme planning to district level; promoting DOTS services beyond the health sector through the adoption of multisectoral approach, and the promotion and scaling up of TB/HIV collaborative activities in countries.

According to him, two new recently launched global initiatives had opened up new opportunities for countries to take to scale the implementation of the DOTS strategy in the African Region.

These are the Global TB Drug Facility (GDF) and the Global Fund for AIDS, TB and Malaria (GFATM). The GDF, operational since 2001, has so far awarded anti-TB drugs grants to 18 African countries to complement the efforts of national governments. These awards have considerably boosted DOTS coverage in recipient countries. For its part, GFATM, operational since 2002, has made available more than $55 million to 16 African countries which submitted proposals with TB or HIV/TB components.

In his remarks, the Director of the Division of Communicable Diseases Prevention and Control at WHO Regional Office for Africa, Dr Antoine Kabore, said that the constantly improving indicators in TB control showed that African countries were determined to bring TB under control in the Region.

"Our Region is still far from the global targets for treatment success and detection. We should therefore redouble our efforts by using proven interventions such as DOTS to reach those at highest risk of TB," he said. "The drugs, the tools, the technology and the strategies (for TB control) are all available. The challenge is for enhanced political will to scale up action and tame the deadly disease".

The latest WHO estimates (March 2001) show that close to two million Africans develop TB every year, with at least 600, 000 others succumbing to it. About 30-50% of all newly diagnosed TB cases in the Region are also infected with HIV. At least 40% of all AIDS deaths in the Region are due to TB.

Africa still has some of the highest TB prevalence rates in the world, ranging from 100 to 700 per 100,000 general population. This has been attributed to several factors including population increase, unfavourable socioeconomic conditions, displacement of populations due to conflict and the HIV/AIDS pandemic prevailing in most countries in the Region.

For further information, please contact Samuel T. Ajibola
Public Information and Communication Unit 
World Health Organization - Regional Office for Africa 
P.O. Box 6 Brazzaville, Congo. 
E-mail: ajibolas [at] afro.who.int (ajibolas[at]afro[dot]who[dot]int) 
Tel:+ 47 241  39378; Fax: + 47 241 39513