Significant Declines in TB Incidence, Prevalence and Mortality, but MDR-TB Remains a Threat

Author:

David Garmaise

Article Type:

Article Number: 7

ABSTRACT According to the Global Fund’s “Update on Results and Impact” report, significant progress has been made against TB, but the multiple-drug-resistant form of the disease is still a significant threat.

TB mortality has decreased significantly since 2000 and treatment success rates have shown steady improvement. More than half of the countries that have received Global Fund support are on track to meet the international targets for case detection, treatment success, and TB disease incidence. However, multi-drug-resistant TB (MDR-TB) remains a critical threat.

These observations were contained in the Global Fund’s “Update on Results and Impact” report published on the eve of the Fund’s pre-replenishment meeting in Brussels, Belgium on 9–10 April.

Up to the end of 2012, the Global Fund disbursed $2.9 billion for TB diagnosis and treatment.

The report said that of the 1.1 billion new smear-positive cases reported in 2012, 83% were from 22 so-called “high-burden” countries. Since 2002, 70 percent of all cases were from the East Asia and South Asia regions. However, the report noted, the sub-Sahara African region has seen a faster rate of increase in recent years, particularly in Nigeria, the Democratic Republic of Congo, Angola, Cameroon and Mozambique. These five countries accounted for one-third of all new smear-positive cases in sub-Saharan Africa in 2012.

According to the Global Fund, global trends in TB incidence, prevalence and mortality suggest that the TB Millennium Development Goals will be achieved, and that additional investments could significant reduce TB even further, particularly given the availability of new diagnostic tools.

The report said that TB prevalence surveys show that community DOTS (directly observed therapy, short-course) initiatives have been very successful in increasing coverage and have led to significant declines in TB prevalence.

MDR-TB still a threat

In 2012, 69,000 MDR-TB cases were treated through Global Fund-supported programmes, an increase of 22% compared to 2011. According to the Global Fund, this is insufficient to face the challenge of MDR-TB. The report estimates that 250,000 cases annually of MDR-TB are left untreated each year. The main challenges in many countries have been inadequate funds to expand diagnosis and treatment, limited technical capacity and weak health systems.

The “Update on Results and Impact” report is available on the Global Fund website here.

This is one of a series of GFO articles on the documents released by the Global Fund for the pre-replenishment meeting in Brussels.