Message of WHO Regional Director for Africa, Dr Matshidiso Moeti
In 1882, when Robert Koch discovered Mycobacterium tuberculosis, the microbe that causes tuberculosis, the disease sent shock waves throughout the world. Transmitted through droplets from sneezes, coughs, or talking, tuberculosis killed the rich and poor alike. In the century that followed, TB (short for tuberculosis) has been forced to retreat thanks to antibiotics and a vaccine that protected infants, and vibrant campaigns. Today, wiping it out completely is within reach.
We commemorate World TB Day yearly on March 24 to raise public awareness about the devastating health, social and economic consequences of this preventable disease and call for accelerated action to end it. This year’s theme is “Yes, we can end TB,” highlighting the need to ensure equitable access to prevention and care, in line with our drive towards Universal Health Coverage and the Sustainable Development Goals.
In 2021, with a clear roadmap, the WHO in the African Region showed that it is possible to reach – and even surpass –the first milestone of the End TB Strategy (20% reduction by 2020), with a decline rate of 22% in new infections since 2015.
Through our technical support, leading advocacy, and effective partnerships, enormous progress has been made over the past decade, especially in the East and Southern African Regions. High-burden countries, like Ethiopia, Kenya, Lesotho, Namibia, South Africa, Tanzania, and Zambia have surpassed or reached the 20% target of reducing new TB cases.
The WHO in the African Region is now on the threshold of reaching a 35% TB death reduction: there has been a 26% reduction in TB deaths between 2015 and 2021. Seven countries— Eswatini, Kenya, Mozambique, South Soudan, Togo, Uganda, and Zambia—have reached a 35% reduction in deaths since 2015.
However, across the region, the challenges in TB prevention and control are significant:
First, the delayed diagnosis and testing. There is still a notable gap between the estimated number of new infections and case notifications of TB: 40% of people living with TB did not know of their diagnosis or it was not reported in 2021. One million people are living with TB in the region and have not been detected.
Second, the link between TB and HIV. Approximately 20% of people newly diagnosed with TB are also living with HIV infection.
Third, the multi-drug resistant TB. In the African region, only 26% of all people living with multi-drug resistance are receiving the appropriate treatment.
Still, I am delighted that our Member States are increasing the uptake of new tools and guidance recommended by WHO, resulting in early access to TB prevention and care, and better outcomes. In the African Region, the use of rapid diagnostic testing has increased from 34% in 2020 to 43% in 2021, which will improve countries’ ability to detect and diagnose new cases of the disease.
It is particularly important to find and diagnose cases of TB so that the patients can be treated, and their contacts offered preventive medication. Nigeria is an example of a country that managed to significantly increase national TB case finding by 50% in 2021 using innovative approaches such as the expansion of the daily observed treatment protocols, use of digital technologies, Community Active Case Finding, and enlisting Public Private Mix initiatives.
TB requires concerted action by all sectors: from communities and businesses to governments, civil society and others.
We must work together to develop innovative approaches to reach vulnerable populations and ensure that they have access to quality TB care and management.
The second UN High-level Meeting on TB in September 2023 will provide a rare opportunity to give global visibility to the disease and mobilize high-level political commitment to end TB.
Ending TB is feasible with the decline in TB deaths and cases, and the elimination of economic and social burdens associated with it.
Specially today, I urge leaders, governments, partners, communities, and all stakeholders to urgently foster the resilient health systems required to accelerate the TB response so that we can reach the Sustainable Development Goals targets by 2030.
Yes, we can end TB in our lifetime.