Washington, DC, March 21, 2002 (PAHO) - Tuberculosis (TB) continues to be a serious health problem in the Americas, where some 250,000 TB cases and nearly 20,000 deaths due to TB are reported annually. The highest rates are in the countries with the lowest incomes, with strong impact on personal and family income as well as the national economy.

Fighting tuberculosis is necessary to achieve greater prosperity, and PAHO is concentrating its efforts on a new treatment strategy that is yielding good results, he said. "Stop TB, Fight Poverty" was the World TB Day theme proposed to member countries this year, which marks the first Centennial of the Organization.

"Improving health is one concrete, quantifiable way to reduce poverty and inequity, both in the countries and on a worldwide scale. Investments in health represent investments in human potential," Dr. Alleyne said.

A work force that suffers from disease cannot contribute to a healthy economy and poor workers and farmers remain poor if they are sick. Confronting diseases of poverty is one way of returning billions of dollars to the national economies of the poorer countries, he noted.

The UN Millennium Summit in September 2000 committed to cut TB mortality by half in ten years, and the World Health Assembly has adopted global TB control goals for 2005 that include detecting 70 percent of infectious TB cases and successfully treating at least 85 percent of them. Progress toward these goals should be possible with high-level political support, new financial donors, problem solving, strategic planning and development of new tools.

Dr. Alleyne said that the drive to stop TB and fight poverty is a campaign for the entire year, emphasizing that it is an appeal to the global community to expand treatment to stop TB.

DOTS is a simple strategy of brief treatment under direct observation, that cures most people who have TB. The cost of the drug is between $10 and $15 dollars per patient. A single person who has contagious TB and is not treated can infect 10 to 15 other people per year.

Dr. Rodolfo Rodríguez, Regional Adviser on TB for PAHO, said that studies indicate each person with TB loses three to four months of work, on the average, as a result of TB. This means a person with TB will lose 20 to 30 percent of his or her income for the year. Families of people who die of the disease lose an average of 15 years of earnings due to the premature death of the patient with TB.

Dr. Rodríguez added that the DOTS strategy is a cost-effective health intervention. "Increasing public knowledge about effective interventions such as DOTS and providing greater access to treatment for people with TB will help recover billions of dollars for the economies of our countries," he said.

"In the Americas, TB continues to be a serious health problem and although 25 countries use the DOTS strategy, many still carry it out on a small scale," Dr. Rodríguez said. The objectives of this year, he added, are to:

1. 1. Emphasize the expansion of the DOTS strategy. It is calculated that only 1 in 3 cases of TB receive treatment using the DOTS strategy. Its expansion is key to control TB, to meet global targets for 2005, and to attack poverty.
2. 2. Increase awareness among political leaders and decision makers about the implications of TB, especially economic implications, and the fact that there is no excuse for not taking action, in light of available and cost-effective cures.
3. 3. Mobilize TB patients to demand greater access to diagnosis, treatment and rehabilitation so they can become productive members of society.

PAHO's annual report notes that TB continues to represent a serious threat for children and adults of the Americas. In 1999, seven percent of the world's cases were reported in the Americas, about half of those in just two countries: Brazil (33 percent) and Peru (17 percent.) Those two countries are among the 22 that have the highest burden of TB morbidity in the world. The TB rate in the region is around 29 cases per 100,000 population (238,082 cases) of all forms of tuberculosis, and 17 new positive pulmonary cases per 100,000 population (137,675 cases). Distribution of new diagnosed cases shows that the impact is greatest in the age group between 15 and 55 years old.

In 1999 additional technical and financial resources were obtained for the introduction of DOTS and for tuberculosis campaign activities in the Americas. As a result, the cure rates in countries that have used the DOTS strategy with complete coverage is much higher (85 percent) than in countries without complete coverage with that treatment (46 percent).

PAHO is supporting strengthening of national, state and local laboratory networks for tuberculosis diagnosis. In addition, as a result of better use of the DOTS strategy, the infectious state of patients is controlled more quickly, giving greater protection to family members, health workers and other members of the community.

The struggle against drug-resistant tuberculosis agents has become a priority in the Americas. Chile, Cuba, the United States, and Uruguay systematically monitor drug resistance. National surveys have also been conducted in several countries.

Diagnosis and treatment services have been decentralized, passing from specialized hospitals to the local primary health care centers and to family and community health care services. The implementation of the DOTS strategy, the Stop TB initiative, and the DOTS-Plus strategy in countries with high disease rates have promoted alliances with new partners-institutions, research centers, universities, faculties of nursing and NGOs, -both within and outside the Region.

The Pan American Health Organization, founded in 1902, is celebrating 100 years of public health work in the Americas this year. Based in Washington, it has offices in 27 countries and nine scientific and technical centers, all working to improve the health of people in the Americas. It also serves as the Regional Office of the World Health Organization.

Related Information:
PAHO BOOK: Tuberculosis Control : A Manual on Methods and Procedures for Integrated Programs