Oct 17, 2018 | Updated: 04:34 PM EDT

Tuberculosis: Reports, Projections, and Aspirations

Oct 23, 2014 03:34 PM EDT

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Tuberculosis (TB) has gained the reputation of being a disease more prevalent in poorer countries or what some may call "third world countries". In recent years, the disease has been overlooked by many, simply because its long existence has made people view it as a disease too easy to cure, with the myriad readily available medicines in hospitals or nearby drugstores. People, especially in affluent countries, just don't take TB seriously. And others think of it as easily manageable, passing off the opportunity to having themselves checked for the disease.

However, the World Health Organization (WHO) says otherwise. As a matter of fact, just recently, it revealed in its Global Tuberculosis Report 2014 that with over 9 million people infected and 1.5 million deaths in 2013, TB is actually the world's second greatest killer disease from a single infectious agent, rivalled only by HIV/AIDS. The report also disclosed that there are half a million more TB cases than had previously been estimated, meaning many TB-stricken individuals have not been diagnosed at the onset of the disease. This leaves the possibility that there could be "more" out there who do not even know that they have contracted TB, continuing to pass the disease along without knowing.

The report said that roughly 3 million people with tuberculosis are being missed by health systems through either lack of diagnosis or failure to report diagnoses, making TB an unacceptably deadly disease despite the treatment and cure available everywhere. In addition, it also said that over 95 per cent of TB deaths occur in low- and middle-income countries.

The WHO said that TB cases have been on a decline over the years, with an estimated 37 million lives saved between 2000 and 2013 through early diagnosis and treatment. Since 1990, mortality rate from TB has fallen by 45 per cent, and the number of people developing TB has also been dwindling by an average of 1.5 per cent every year.

This being said, we can come to the conclusion that treatment for the disease has vastly improved over the years, and the trend should continue with the unceasing developments in medicine, with more researches emerging to come up with the best and fastest-- but not necessarily the priciest-- cure for the illness.

However, the WHO study also said that the case for multidrug-resistant (MDR) -TB remains alarming - with an estimated 480,000 new cases in 2013, accounting for about 3.5% of all new TB cases in the said year. MDR-TB brought severe epidemics in some regions, particularly in Eastern Europe and Central Asia, the report said.

According to the WHO MDR-TB is difficult to treat and has significantly worse cure rates than standard TB. Globally, only 48% of MDR-TB patients were cured in 2013, which could be attributed to its high cost of treatment.

Grania Brigden, a TB expert with the charity Medecins Sans Frontieres said that the "alarming spread of drug-resistant TB from person to person in the former Soviet Union is of critical concern, along with the growth in MDR-TB and and extensively drug-resistant XDR-TB [another strain which is more difficult to treat] cases."

"Access to proper treatment is drastically low: Only 1 in 5 people with multidrug-resistant TB receives treatment; the rest are left to die, increasing the risk to their families and communities and fueling the epidemic," she said, highlighting the difficult access of treatment for the disease, either due to its cost or available means of diagnosis.

Dr. Karin Weyer, WHO coordinator for Laboratories, Diagnostics and Drug Resistance, saysthat though MDR-TB is a difficult disease to treat, it still could be treated as in the case of Estonia and Latvia where the number of MDR-TB has decreased dramatically. She said, "Improved diagnostic tools and access mean that we are detecting and treating more cases. But the gap between detecting and actually getting people started on treatment is widening and we urgently need increased commitment and funding to test and treat every case. In countries such as Estonia and Latvia, where there is universal access to rapid diagnostics and treatment, the number of MDR-TB cases has fallen significantly. This shows what can be achieved."

On the positive side, the WHO report showed that treatment success rate among new TB cases remained high with treatment success rate recorded at 86 per cent for new TB cases.

The trend seems likely to improve especially that most nations are looking to achieve the targets set in the United Nations' Millennium Development Goals (MDGs), which is to halt and reverse TB incidence globally. Efforts have been evident as far as improving treatment/cure for the disease is concerned as the WHO report also mentioned the many new developments in TB diagnostic technologies, as well as drugs currently on their late phases of clinical development. Add to this the 15 vaccine candidates in clinical trials.

The WHO also said that since 2002, there has been substantial growth in funding for TB prevention, diagnosis, and treatment, and for 2014 alone, a total of $6.3 billion was accounted for funding of TB-related activities. Despite the increased financial support from more affluent countries and organizations, there is still a $2 billion shortage to fully provide treatment to TB patients all over the world.

The report released by WHO on TB looks staggering, with head and monetary figures too overwhelming, but with full cooperation from all nations--who are by the way, all susceptible to contracting the disease--through policy review and development and through technological innovations, the disease could be managed, controlled, and stopped, with careful strides to be undertaken by everyone and every nation. One of the concerns presented by the WHO TB report was early diagnosis which could lead to better treatment facilities to TB patients, and it is high time that all nations' healthcare system include TB testing especially that TB could have no detectable symptoms in its early stages.

After MDG 2015, the WHO will look at a post-2015 development framework with a created strategy called "the End TB Strategy" whose goal is to end the global TB epidemic, and achieve 95 per cent reduction in TB deaths, and 90 per cent reduction in TB incidence by 2035.  

The goal looks ambitious, but with the given timeframe and a projected drastic improvement in TB research, medical facilities and technology, achieving a 100 per cent TB-free world even earlier than the projected 2035 is not so fat-fetched after all.

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