World TB Day marks a major turning point
World TB Day, which is observed on 24 March each year, marks a major turning point in public health history. On that day in 1882, Dr Robert Koch of Germany identified the bacillus that causes tuberculosis, an infectious disease so devastating that it was then known in Europe as "the white plague". It took another 60 years before antibiotics rendered the disease
curable; and even today, with effective treatment available, the World Health Organization reported there were 9.2 million new cases and 1.7 million deaths in 2006.
World TB Day was launched in 1982 to mark the 100th anniversary of Koch's discovery. Countries around the world use marches, street theatre, murals, media workshops, government briefings and other events to educate people about the symptoms of TB; build awareness of the need for resources, including new TB diagnostic tools and drugs; and celebrate the survival of those who have recovered.
For organisations such as the 89-year-old International Union Against Tuberculosis and Lung Disease (The Union), World TB Day serves an important purpose. "It's a reminder to everyone that the fight against tuberculosis is ongoing. It hasn't been won yet," says Dr Nils E Billo, Executive Director of The Union.
The theme for World TB Day, "I am stopping TB", emphasizes the wide-ranging effort required to prevent, treat and control TB. "To be successful, we need commitment at every level from government ministers and international donors to health care professionals, researchers, patients and families affected by TB," says Billo.
The Union, with headquarters in Paris, as well as regional offices and members in more than 100 countries, provides direct field assistance to some 80 countries each year, conducts research and organises international conferences and courses.
Billo notes that, since the first World TB Day, global tuberculosis control efforts have seen both significant successes and difficult new challenges:
* Since 1995, more than 31.8 million patients in 184 countries have been treated through the WHO-approved Stop TB Strategy, which is based on a treatment model originally developed by Union researchers.
* The Stop TB Partnership formed in 2000 by the World Health Organization, The Union and other TB organisations has grown into a formidable advocate for a disease that disproportionately affects the poor and voiceless. Today more than 1,000 organisations are members of the Partnership, which has developed the Global Plan to Stop TB 2006 – 2015 and meet the UN's Millennium Development Goals.
* Increased awareness has generated more resources. Funding for TB has increased from less than $1 billion in 2002 to more than $3.3 billion in 2008. The Union recently received a 5-year grant for up to US$ 80 million from the US Agency for International Development for its TREAT TB initiative. Dr I.D. Rusen, Director of The Union's Tuberculosis Department, calls this level of funding "unimaginable" a few years ago.
Other developments illustrate that tuberculosis remains a continuing threat to public health:
* The increasing incidence of extensively drug-resistant tuberculosis (XDR-TB) makes clear that without effective well-funded TB control programmes and the development of new drugs and diagnostic tools, incurable strains of tuberculosis will emerge.
* Tuberculosis is now the number one cause of death among people infected with HIV, and integrated services to address this TB-HIV co-epidemic are critically needed, according to Dr Paula I Fujiwara, Director of The Union's HIV Department.
* The spread of TB, including multidrug-resistant TB, is facilitated by today's highly mobile populations. TB control policy has to take into account not only issues of public health, but also of human rights. For example, a Union Working Group has studied the problem of reaching and treating undocumented immigrants with TB. Its recommendations stress the need for patient confidentiality, free diagnosis and treatment, and recognition of the problems created if patients can not or do not finish their treatment.
* Despite the significant increase in resources for TB, approximately $1 billion more funding per year is needed to implement the Global Plan to Stop TB.
The current economic crisis is also expected to have an impact on TB. The 22 countries with the highest burden of the disease — nearly 80% of the cases — are also among the world's poorest.
This and other issues will be discussed at the 40th Union World Conference on Lung Health, on 3-7 December in Cancún, Mexico, where the theme will be "Poverty and Lung Health".
Useful links:
World TB Day 2009
WHO 2009 Global Tuberculosis Report