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Bulletin of the World Health Organization

Print version ISSN 0042-9686

Bull World Health Organ vol.79 n.5 Genebra Jan. 2001

http://dx.doi.org/10.1590/S0042-96862001000500023 

A day in the life of the world's anti-TB drive

In March, WHO and the Stop TB partnership launched a US$ 50 million-a-year initiative to provide free drugs to 10 million tuberculosis patients over the next five years. By 2010, the Global TB Drug Facility, as the initiative is called, aims to reach 45 million patients in the worst-affected countries. By 2020, it hopes to have prevented 25 million TB deaths and 50 million cases.

The new drug facility was launched in the run-up to World TB Day, 24 March, which this year focused on tuberculosis as a human rights issue. In announcing the new facility, WHO director-general Dr Gro Harlem Brundtland said access to treatment and cure was basic to human rights. ‘‘It is shameful that TB patients are still dying of the disease, and inexcusable that less than a quarter of them have access to effective treatment.’’

In its annual report on global tuberculosis control, also issued in the run-up to World TB Day, WHO estimates that 8.4 million people contracted TB in 1999 — up from 8 million in 1997. The biggest increase in cases since 1997 was in sub-Saharan Africa, which experienced a 20% surge in cases due to the high rates of people co-infected with HIV and TB. About two million people die from TB every year, half a million with concurrent HIV infection.

Although TB is curable, only 23% of people with active TB have access to DOTS, formerly an acronym for ‘‘directly observed treatment short-course’’, but now a ‘‘brand name’’ for a broader anti-TB package.

Unless the current trend can be reversed, says WHO, there will be 10.2 million new TB cases a year by 2005. And the goal of detecting 70% of cases through DOTS and curing 85% of them will not be reached until 2013 — eight years later than the global target set at a ministerial conference held in Amsterdam in March 2000. And that’s not to mention multidrug-resistant TB, which is on the increase in many places, particularly in the former Soviet Union, where it has been encountered in up to 14% of new TB cases.

The Global TB Drug Facility was launched in Washington DC on 21 March, with an initial US$ 10 million from the Canadian International Development Agency (CIDA). The first grants have now been approved to provide drugs to treat almost 200 000 patients in Africa, Asia, and Eastern Europe.

Dr Jacob Kumaresan, executive secretary of the WHO-based Stop TB partnership, told the Bulletin: ‘‘The drugs used to treat TB have been available for over three decades, and the 6–8 month course of treatment for TB costs as little as US$ 10–15. But shortages of TB drugs are frequent and serious, often caused by financial constraints, inefficient drug procurement systems, and poor management. With the TB Drug Facility we will be able to ensure an uninterrupted supply of high-quality drugs, which should help to expand rapidly the use of DOTS.’’

Meanwhile, sympathisers of the anti-TB movement have taken advantage of World TB Day to give material expression to their support: the Bill and Melinda Gates Foundation announced a gift of US$ 10 million to the WHO-based tropical disease research programme (TDR) to fund the development of better diagnostic tests for TB, and the Dutch government offered 20 million Dutch Guilders (about US$ 8 million) to the Stop TB partnership.

Sheila Davey, Geneva, Switzerland