Today is World Tuberculosis (TB) Day. It is a day when the whole world is reminded of the menace that TB continues to pose to humanity despite the existence of effective control interventions. As in 2010, the theme for this year’s World TB Day is “Innovation”; and the slogan is “On the move against tuberculosis”.
Tuberculosis is a major public health problem in the WHO African Region. The 2010 WHO Global TB Control Report indicates that the African Region, accounting for about 12% of the world population, recorded 23% of notified TB cases worldwide in 2010. The high TB burden is linked to the emergence of new challenges such as TB/HIV co-infection and multidrug-resistant TB.
Despite the fact that Member States have almost universally adopted the “Stop TB strategy”, full implementation of this strategy is still weak. For instance, only 49% of the estimated TB cases are detected annually. In 2008, only 12 countries in the Region reached the internationally-recommended target of detecting at least 70% of estimated new cases. The Region is also not in full control of treatment as only 13 countries attained the internationally-recommended treatment completion target of having at least 85% of those on treatment complete their recommended courses of therapy.
Occurrence of both TB/HIV co-infection and drug resistant forms of the disease complicates TB control in the Region. On average, 35% of all TB patients in the Region are also infected with HIV. To date, 33 countries in the Region have reported at least one case of Multi drug -Resistant TB (MDR-TB) and 8 of them have reported at least one case of Extensively Drug -Resistant TB (XDR-TB).
Major impediments to accelerated scale up of control activities include the lack of or inadequate facilities for rapid and accurate diagnostic tests at the community level; the prolonged duration of treatment (6-8 months), difficulty in diagnosing drug resistant TB and uncoordinated management of TB and HIV programmes in countries. The Global Plan to Stop TB (2011-2015) has set new targets for TB control, transforming the fight against TB to the fight to eliminate the disease. This requires specific actions by countries as well as public and private institutions and other stakeholders in the fight against TB.
Special innovative actions are required to deal with the continuing challenges of TB. Innovations are required in the development of new vaccines and scaling up rapid diagnostic tests to reduce the risk of transmission of TB. In addition, there is an urgent need for strategies that will strengthen health systems, and engage all health care providers (including those in the private sector) in TB care. Improving access to general health care that will facilitate early detection of TB among the vulnerable populations is critical. Ensuring full testing of HIV in all TB patients is equally important; as is increasing access to care for those who are dually infected with HIV and TB.
The theme and the slogan of World TB Day 2011 respond directly to these needs. To this extent, 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. The recent approval of the new rapid diagnostic test for TB and drug resistant TB by WHO and partners is a case in point. WHO will support countries to adapt the new rapid test which combines the diagnosis of TB and MDR-TB in a single test. WHO is also supporting the introduction of TB training courses in universities and institutions of higher learning in the region, with the aim of building the capacity of health workers for TB care, and also to strengthen health systems in general. The first course is due for launch in April 2011 at the Regional Institute for Public Health in – Ouidah, Benin Republic.
I would therefore like to use this occasion to call on national authorities to strengthen national Stop TB Partnerships so that they are able to mobilize additional resources for TB control from governments, the private sector and other partners to enable countries to move towards TB elimination. This is especially important in the context of the economic and financial crisis facing our Region.
With only four years to the target date for the achievement of the Millenium Development Goals, these and many other actions are urgently needed to ensure progress in TB control in the African Region. Governments and 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 in 2011 and beyond.
Thank you