Putrajaya, Malaysia, 13 October 2010—The World Health Organization (WHO) and its Member States in the Western Pacific today vowed to renew efforts against multidrug-resistant TB and the TB-HIV co-infection in order to protect gains in tuberculosis control in the Region.
The Western Pacific Region is expected to achieve its 2010 goal of cutting by half TB prevalence and mortality in relation to 2000 levels. But danger looms unless countries in the Region take urgent measures to address threats posed by multidrug-resistant TB (MDR-TB) and TB-HIV co-infection.
To address these challenges, WHO Member States today endorsed the Regional Strategy to Stop Tuberculosis in the Western Pacific Region (2011–2015). The strategy builds on two previous regional plans, but adds new evidence-based interventions and technologies.
The annual meeting of WHO's Regional Committee in Putrajaya, Malaysia, was told that the Western Pacific Region must overcome a number of issues to combat the threats of MDR-TB and the TB-HIV co-infection. These include:
- a case detection rate that is too low to stop the chain of transmission;
- insufficient laboratory capacity for early diagnosis of TB and for effective responses to MDR-TB and the TB-HIV co-infection;
- lack of qualified human resources, quality-assured drugs and infection-control activities, which slowed progress in the scale-up of MDR-TB programme management;
- limited TB-HIV collaborative activities; and
- insufficient programme management capacity to acquire and manage donor grants and expand related programme operations.
"These challenges require firm political commitment and financial input to develop and implement comprehensive scale-up plans," said Dr Shin Young-soo, WHO Regional Director for the Western Pacific. "There is a need to develop policies and legislation that ensure proper treatment with quality drugs by all providers."
While the WHO-recommended strategy known as directly observed treatment, short course, or DOTS, has been successful in bringing down the number of TB cases in the Western Pacific Region from 3.5 million in 2000 to 2 million in 2008, the problem of drug resistance remains a serious concern. MDR-TB is being fuelled by inadequate treatment in the private sector, self-medication, over-the-counter sales of TB drugs and drugs of poor quality.
A major weakness in all TB high-burden countries—Cambodia, China, the Philippines and Viet Nam—has been inadequate implementation of interventions to reduce the TB burden among people living with HIV. These measures include intensified TB case finding, isoniazid preventive therapy (taking a pill daily for a number of months to prevent the development of active TB), and ensuring infection control in health facilities.
To view the French version
- Global TB incidence has seen a reversal since 2004.
- Most recent global estimates indicate that some 9.4 million people are still suffering annually from TB, resulting in 1.3 million deaths.
- approximately 1.4 million TB patients are co-infected with HIV.
- The emergence and silent spread of drug-resistant TB, particularly multidrug-resistant TB (MDR-TB) poses serious public health challenges.
- More than 440 000 MDR-TB cases occur every year, of which only a small portion of cases has been properly diagnosed and treated.
- MDR-TB scale-up is hampered by the lack of:
- laboratory networks
- qualified human resources
- effective links with private and hospital sectors
- models of care that ensure adherence to long and complicated treatment regimens
- quality-assured, second-line drugs, and
- infection control.
Western Pacific Region
- Approximately 1.9 million new TB cases and 260 000 TB deaths are estimated annually.
- Cambodia, China, the Philippines and Viet Nam—four among the 22 global high-burden countries—account for 93% of the regional case load.
- There are about 120 000 new MDR-TB patients annually, or about 28% of the world's MDR-TB burden.
- Surveillance data in 2008 indicate that 4% of new cases and 24% of previously treated TB patients in the Region were suffering from MDR-TB.
- China, the Philippines and Viet Nam account for 97% of the total number of estimated MDR-TB cases in both new and re-treatment cases.
- In 2007, the overall estimated HIV prevalence in new TB cases was 2.7 %, with levels ranging from less than 1% to 15% in countries in the Region.
- Only 11% of new TB patients received HIV testing in 2008 despite implementation of TB-HIV collaborative activities.
- Among patients found to be co-infected with TB and HIV, only 18% were enrolled in antiretroviral treatment.