Tuberculosis response still seen as global health failure

The World Health Organisation (WHO) sees slow gaps of tuberculosis response in countries as a challenge to tackle the world’s deadliest infectious disease, however calls all political leaders to take decisive action.

A release made available by the organisation on 18th September, advocates that political leaders gathering next week for the first-ever United Nations high-level meeting on TB will provide historic opportunity in tackling the epidemic.

The report reveals that although global efforts have averted an estimated 54 million TB deaths since 2000, but TB remains the world’s deadliest infectious disease.

“Countries are still not doing enough to end TB by 2030, warns the World Health Organization (WHO).

Tedros Adhanom Ghebreyesus, WHO Director-General said we have never seen such high-level political attention and understanding of what the world needs to do to end TB and drug-resistant TB, “We must capitalize on this new momentum and act together to end this terrible disease.”

“To meet the global target of ending TB by 2030, countries need to urgently accelerate their response including by increasing domestic and international funding to fight the disease,” Ghebreyesus said.

The report further says that WHO estimates that a quarter of the world’s population has TB infection.

“Drug-resistant TB remains a global public health crisis showing that in 2017, 558 000 people were estimated to have developed disease resistant to at least rifampicin – the most effective first-line TB drug.

“The vast majority of these people had multidrug-resistant TB (MDR-TB), that is, combined resistance to rifampicin and isoniazid which is another key first-line TB medicine,” the report states.

However, the WHO report provides an overview of status of the epidemic and the challenges and opportunities countries face in responding to it,

The report reveals that underreporting and under-diagnosis of TB cases remains a major challenge of which 10 million people who fell ill with TB in 2017, only 6.4 million were officially recorded by national reporting systems, leaving 3.6 million people undiagnosed, or detected but not reported.

Ten countries accounted for 80 per cent of this gap, with India, Indonesia and Nigeria topping the list.

Another of it challenge show that less than half of the estimated one million children with TB were reported in 2017, making it a much higher gap in detection than that in adults.

Also treatment coverage lags behind at 64 per cent and must increase to at least 90 per cent by 2025 to meet the TB targets.

The report further states only around half of the estimated 920,000 people with HIV-associated TB were reported in 2017 of these, 84per cent were on antiretroviral therapy.

Most of the gaps in detection and treatment were in the WHO African Region, where the burden of HIV-associated TB is highest. Only one in four people with MDR-TB were reported to have received treatment with a second-line regimen.

Globally, MDR-TB treatment success remains low at 55per cent, often due to drug toxicity making it impossible for patients to stay on treatment.

A month ago, WHO issued a Rapid Communication on key changes to treatment of drug-resistant TB based on the latest scientific evidence. These changes should result in better treatment outcomes and more lives saved. WHO is already working with countries and partners to roll out these changes.

The Organization predicts that at least 30 million people should be able to access TB preventive treatment between 2018 and 2022, based on new WHO guidance. Although preventive treatment for latent TB infection is expanding, most people needing it are not yet accessing care. WHO strongly recommends preventive treatment for people living with HIV, and children under 5 years living in households with TB. Related new guidance was issued by WHO in 2018, to facilitate greater access to preventive services for those who need it.

ANTHONIA OBOKOH