Professor Ali Zumla and members of the UK All-Party Parliamentary Group on Global Tuberculosis (APPG-GTB) have sounded an alarm on the growing threat of multi-drug resistant TB.
In a Lancet Comment discussing the WHO Global Tuberculosis report 2013 published last week, Professor Zumla, the lead author and a BRC researcher, and members of APPG-GTB explained how the increased risk to regional and global health security has become apparent.
“The report details some striking successes towards achieving the Millennium Development Goals (MDGs) and related 2015 targets for global TB control but it also identifies specific areas of concern for which urgent political and funder attention is required”, stated the authors. “In particular, a large number of people remain undiagnosed and untreated and continue to spread TB in the community.”
Despite the achievements—there has been an overall decline in TB incidence and mortality; and the global target of a 50% reduction in TB mortality over the period 1990–2015 seems possible—only around a fifth of the 450 000 people estimated to have MDR-TB in 2012 were detected. Additionally, the success rate of MDR-TB treatment remains below 50% as a result of high levels of death and losses to follow-up.
But the Lancet Comment authors remain confident that these challenges are not insurmountable: “Recent advances in new TB diagnostics, drugs, laboratory methods for detecting MDR-TB, and strategies for proactive screening for TB, now present unique opportunities and fresh solutions…high burden countries, Global Fund, bilateral agency, and pharmaceutical sector commitment is imperative to find solutions to drug supply problems and care capacity which stand in the way of MDR-TB treatment scale-up.”
The authors urged donor and high burden countries to see TB as a top killer alongside HIV and malaria that deserves the same level of collective commitment, adding that, “To address these priority concerns, existing commitments need to be sustained and at least an additional $2 billion US dollars per year is needed. The full replenishment of the Global Fund in 2013 is essential for donor dependent countries, since the fund provides about three-quarters of international donor funding for TB.”
They conclude, “We now have the tools, knowledge, and expertise to achieve global TB control, and the time has come for urgent, swift, and visionary action now to step up TB control efforts and drive down TB incidence rates as rapidly as possible.”
Professor Zumla is Professor of Infectious Diseases and International Health at UCL and a Consultant in Infectious Diseases at UCLH.
To read the Lancet Comment WHO's 2013 global report on tuberculosis: successes, threats, and opportunities in full click here.
