Experts say stepped-up control efforts could make the region TB-free by 2050
Washington, D.C., 23 March 2012 (PAHO/WHO) — Tuberculosis remains the second-leading infectious disease killer in the Americas (after HIV/AIDS) despite significant progress in controlling the disease.
On World TB Day, experts from the Pan American Health Organization/World Health Organization (PAHO/WHO) said TB could be eliminated from the region if countries intensify their efforts and if all of society joins in the fight.
“It is my aspiration that one day in the not-too-distant future, we will see an America free of tuberculosis,” said PAHO Director Dr. Roses in a message marking World TB Day. “This goal can only be met with commitment from everyone.”
Currently an estimated 23,000 people die each year from TB in the Americas, and 270,000—including 44,000 children—become sick with the disease. But these numbers reflect major progress in recent decades. Since 1990, TB cases have declined by 60 percent in the region, and TB deaths have declined by two-thirds.
The burden of TB varies substantially across the countries of the Americas. Haiti, Suriname, Bolivia, Guyana and Peru have the highest incidence, ranging from 106 to 230 TB cases per 100,000 people in 2010. Brazil has lower incidence but the highest absolute number of cases: 85,000 in 2010. Canada, Cuba and the United States have the lowest rates, with under 10 per 100,000.
Within countries, the disease takes a disproportionate toll on disadvantaged individuals and communities. “TB can affect anyone, including children and young people, and especially members of poor and marginalized groups, which has a negative impact on human development,” said Dr. Roses.
PAHO/WHO member countries have set the goal of eliminating TB from the Americas by 2050. In her message for World TB Day, Dr. Roses called on governments, civil society, communities, patients, and other individuals to support TB control efforts by helping to spread this year’s global campaign message “Stop TB in my lifetime.”
Progress in the countries of the Americas has been achieved largely through the implementation of WHO’s Stop TB Strategy, with PAHO support. The strategy emphasizes timely diagnosis and universal treatment with proper combinations of anti-TB drugs. A key component of the strategy is directly observed therapy – short course (DOTS), whereby health workers directly monitor patients’ adherence to their medication regimes.
Despite the steady progress in reducing the burden of TB, countries in the Americas still face obstacles to its elimination. Among the most important are:
- The spread of MDR-TB, or multidrug-resistant tuberculosis, which does not respond to first-line drugs (about 3 percent of all notified cases) and the emergence of XDR-TB, or extensively drug-resistant TB, which does not respond to commonly used second-line drugs.
- An increase in coinfections of TB and HIV/AIDS (an estimated 35,000 cases in 2010).
- Health system weaknesses in many high-TB-burden countries, particularly in primary health care.
PAHO experts say overcoming these obstacles will require continued implementation of the Stop TB Strategy, but with improvements in several key areas:
- Strengthened DOTS for every patient, and expanded community support.
- Increased collaboration between TB and HIV programs.
- Introduction of new tools for rapid diagnosis in laboratory networks.
- Universal access to care for all MDR-TB cases.
- Strategies and interventions for vulnerable populations, especially children.
These challenges can be met if TB programs are given sufficient political, financial, managerial and social support, experts say.
“Our countries have made great progress in reducing the burden of TB, but it is important now to strengthen our efforts,” said Dr. Mirtha del Granado, PAHO Regional Advisor on TB. “We also must remind the public that TB continues to threaten people’s health, so they must continue to support and participate in efforts to control TB.”
TB is caused by Mycobacterium tuberculosis, a bacterium that most often affects the lungs. About one in three people worldwide has latent TB, meaning they are infected but have no active symptoms of the disease and cannot transmit it.
TB is spread through the air when people with active lung infection cough, sneeze or spit. The lifetime risk of someone infected becoming ill is 10 percent. However, people with compromised immune systems, such as those with HIV, malnutrition or diabetes, or people who use tobacco, have a much higher risk of falling ill. Symptoms of pulmonary TB include a cough that lasts for more than 2-3 weeks, weight loss, fever, night sweats, loss of appetite and coughing up blood. The disease is curable, but can be fatal if left untreated. Treatment usually takes six months and costs as little as US$100 in many developing countries.
World TB DAY, March 24
World TB Day commemorates the day in 1882 when Dr. Robert Koch announced that he had discovered the cause of tuberculosis, the TB bacillus. At the time of his announcement in Berlin, TB was raging through Europe and the Americas, killing one out of every seven people. Koch's discovery opened the way toward diagnosing and curing TB.
- PAHO Tuberculosis program
- PAHO Director’s Message, World TB Day 2012 (Spanish)
- World TB Day website
- Stop TB Strategy
- Stop TB Partnership
- WHO Tuberculosis program