The World Health Organization (WHO) has declared March 24, 2016 as World Tuberculosis (TB) Day . Over the month of March, the Global Health Office will be publishing a series of blog posts about TB in hopes of raising awareness of its worldwide impact. WHO’s “End TB Strategy” has a goal of ending the TB epidemic by 2030, by targeting poverty, improving testing and treatment, ending stigma and discrimination, and driving research and innovation. Put simply, TB is not yet a disease of the past, but if we unite and focus our efforts, we can make TB history.
If you’ve been following our series of TB blog posts, first of all – thank you! By now, you should know what TB is, how it’s diagnosed and how it’s treated, which are all important pieces of background knowledge. But with 1.5 million TB deaths, and 9.6 million new TB cases worldwide in 2014, you’re probably wondering what is being done to address and reduce the significant burden of TB ?
Back in 2000, TB was included in the United Nations (UN) Millennium Development Goal (MDG) framework under MDG 6: combat HIV/AIDS, malaria and other diseases. December 30 2015 marked the deadline for the MDG targets, and it is important to recognize the progress that has been made in the fight against TB since their introduction. TB mortality has fallen 47% since 1990, with nearly all of that improvement taking place since the MDGs were set in 2000. The MDG target to halt and reverse TB incidence has been achieved on a worldwide basis, and in 16 of the 22 high-burden countries that account for 80% of TB cases. TB incidence is now 18% lower than it was in 2000, having fallen by an average of 1.5% per year. Despite these advances, TB remains one of the world’s greatest infectious disease threats .
One of the criticisms of the MDGs was that TB was put on the backburner compared to HIV/AIDS and malaria, which were explicitly named in the MDG 6 title. TB is a part of the UN Sustainable Development Goals (SDGs) under SDG #3: Good health and well-being. In the SDG framework, TB is specifically mentioned, alongside an ambitious target – to end the TB epidemic by 2030. The WHO End TB Strategy has been created to help meet that goal. Compared to 2015, WHO hopes to achieve a reduction in the number of TB deaths by 90% in 2030, and 95% in 2035. In the next five years, WHO aims to reduce the TB incidence rate by 20%. The End TB Strategy has three pillars that will be fundamental in achieving these targets:
- Integrated, Patient-Centered Care and Prevention.
There are many components to patient-centered care, including early diagnosis and drug susceptibility testing in order to achieve the most effective treatment regimen, and prevention and TB vaccination for persons at high risk. Patient support will also be key, given that the treatment regimen can be both lengthy and costly.
- Bold Policies and Supportive Systems
There must be adequate political commitment, and resources allocated to TB care and prevention in order for any of these goals to be met. This will involve engaging communities, civil society organizations, and public and private care providers. Health systems will play a vital role in health coverage, case notification, appropriate use of medicines and infection control. Finally, addressing the upstream social determinants of health, will help to reduce TB incidence among the most vulnerable – those living in poverty.
- Intensified Research and Innovation.
As previously discussed, TB testing and treatment can be strenuous processes. The WHO End TB Strategy advocates for increased discovery, development and rapid uptake of new tools, interventions and strategies in order to address these problems .
Pillar 1 addresses the need to target high risk groups in prevention and treatment efforts. Who are these high risk groups, and how can they be reached? Find out in our next blog post!