Stop TB in the LDCsThe Strategy & The Plan..Dr Pierre-Yves Norval, WHO Stop TB Department 3° workshop for LDCs - July 2006
The burden of TB in 2006 – Global and LDCs
1.7 million deaths in 2004 (500.000 in LDCs)– 98% of these in developing world250,000 deaths
due to TB/HIV(100.000 in LDCs) MDR-TB present in
102 of 109 countries and settings surveyed (10/11 LDCs)
8.9 million new cases in 2004 (2.1 million in LDCs)
Highest incidence rates per capita in Africa
= 300 or more
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Over 22 million patients treated under DOTS (5 million in LCDs) with high cure rates
0
20
40
60
80
100
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Cas
e de
tect
ion
or
cure
rate
(%)
Target cure 85% Target detection 70%
Global incidence is rising largely as a resultof the epidemic in Africa (LDCs) and E. Europe
0
100
200
300
400
1990 1995 2000 2005
Estim
ated
TB
inci
denc
e/10
0K/y
r Africa - high HIV
Africa - low HIV
WorldE Europe
LDCs
The Stop TB StrategyGlobal TB control targets
2015: Goal 6: Combat HIV/AIDS, malaria and other diseasesTarget 8: to have halted by 2015 and begun to reverse the incidence
Indicator 23: prevalence and deaths associated with TBIndicator 24: proportion of TB cases detected & cured under DOT
2015: 50% reduction in TB prevalence and death rates2050: World free of TB
WHA 2005:To detect at least 70% of infectious TB casesTo treat successfully at least 85% of them
Stop TB Strategy to reach the 2015 MDGs
• Vision: A WORLD FREE OF TB• Goal: To dramatically reduce the global burden of TB by 2015 in line
with the MDGs and the Stop TB Partnership targets
International Standard of TB Care (ISTC) & The Patient Charter for TB care
Projected rates of TB incidence
Projected rates of TB prevalence
Projected rates of TB deaths
Current progress are insufficient to reach MDG in each region
• Actions to – Treat 50 million people for TB– Save 14 million lives– Put 3 million HIV+TB cases on ARV– Treat 800,000 people for MDR TB– Produce new anti-TB drug (first in 40 years)– Develop new vaccine– Provide rapid and inexpensive diagnostic tests
• Resources needed to reach MDGs Financial Gap 2006-2015
$56 billion $31 billion
Total available funding and funding gaps for implementation, 2006-2015
Current progress are insufficient to reach TB targets• DOTS quality is the priority especially in Africa. Greatest
need in LDCs for new approaches - ie basic capacity• Sharing best practices to address complex concerns:
– health system strengthening – mobilising people and communities– engage all care providers– research capacity building
• Campaign for the Global Plan ($56 billion)to reach:– 50 million TB patients treated– 14 million lives saved through high quality care– progress in R & D
• Collaboration between partners is key to success• TB elimination by 2050 depends on innovation
Conclusion: phased introduction of the Stop TB Strategy and the Global Plan = solution