Africa Lags in Fight Against TB, WHO Report Says

Tuberculosis has reached “alarming proportions” in Africa, where co-infection with the widespread HIV virus makes a lethal combination, the World Health Organization (WHO) reported on Thursday.

The number of cases of tuberculosis is rising 3 to 4 percent annually across the African continent, though the respiratory disease is being stemmed elsewhere, the United Nations agency said in a report, “Global Tuberculosis Control.”There were an estimated 8.8 million new cases worldwide in 2003, according to the WHO report issued on World TB Day — 2.3 million of them in Africa.”The rate of TB infections has tripled in some African countries since 1990 … In Africa we have to face the fact that we have much further to go,” WHO Director-General Lee Jong-wook told a news conference in London.Most of the victims of TB, a curable disease spread by coughing and sneezing, live in developing countries, and an estimated 1.7 million people died from the disease in 2003.Nearly one-third of the deaths were in Africa where HIV/AIDS is prevalent and health services are weak. TB and HIV form a deadly combination and TB is the leading cause of death among people who are HIV positive.Globally, TB prevalence has dropped by more than 20 percent since 1990, and is “falling or stable” in five of the world’s six regions, according to the WHO. “But for the strongly adverse trends in Africa, prevalence and death rates would be falling more quickly worldwide,” it said. ASIA ON TRACKIndia and China, with their vast populations, accounted for an estimated 1.8 million and 1.3 million new TB cases, respectively, in 2003 for a combined 35 percent of the global total, according to the report.But there has been “tremendous improvement” in the two densely populated Asian powers, where more and more people are receiving treatment, Lee said. Indonesia and Philippines are also making progress.Mario Raviglione, head of the WHO’s Stop TB Programme, attributed the success in Asia to the right mix of government commitment and financial support from the state and donor nations.Nine of the 22 countries hardest hit by TB are in Africa, including Nigeria, Ethiopia, South Africa and Kenya.The U.N. Millennium Development goal is to detect 70 percent of all new infectious cases of TB by the end of 2005, and to cure or treat successfully 85 percent of them.A great effort is required to achieve this in Africa and eastern Europe, where there are high levels of multidrug-resistant TB, the deadliest form, the report said. The latest data show the WHO is three percent short of the targets.Several independent humanitarian organizations issued their own statements to mark World TB Day.The Swiss-based International Committee of the Red Cross (ICRC) said inmates of overcrowded prisons in the southern Caucasus countries of Georgia, Armenia and Azerbaijan are especially vulnerable to the disease.Paris-based Medecins Sans Frontieres (Doctors Without Borders) called for the development of a simple, rapid test for TB in poor countries, where health workers still rely on sputum microscopy.This method, developed 123 years ago, detects TB in only about half of those who have it, and is even less reliable for people with both HIV and TB, the group said in a statement.(Source: Reuters Health, March 2005)