An extra $400 million per year would make quality medicines and treatment services available to at least 70% of the world’s 8 million new tuberculosis (TB) cases each year, the World Health Organization (WHO) said today. Currently, only 23% of TB patients worldwide have access to these services. $300 million of the extra money needed is for the 22 highest-burden TB countries alone.
In a report released today, WHO provides first-time estimates of the cost of reaching global TB control targets by 2005 (70% of TB cases detected, 85% of those successfully treated).
The report, entitled "The Global DOTS Expansion Plan, Progress in TB control in 22 high burden countries, 2001", estimates that nearly US$1 billion per year is needed to control TB in the 22 highest-burden countries. The majority of these resources is provided by country governments themselves. Donor grant funds at present account for less than 5% of the total.
But overall, there is still a $300 million annual shortfall in the 22 countries - or $1.5 billion over the next five years – which will need to be made up if the 2005 targets are to be met.
Globally, expanding the current DOTS efforts will ensure that 5 million TB patients per year will be treated. DOTS is the internationally recommended and most effective strategy available for controlling the TB epidemic.
A year after "The Amsterdam Declaration" where Ministers of Health, Finance and Development from 20 high-TB-burden countries called for accelerated action to expand TB control measures, all these countries have put plans in place to tackle TB, the report shows. Many of these plans already have detailed budgets which spell out what is required for the major inputs—drugs, diagnostics and case-management, training, programme management, dedicated TB service infrastructure and staff. The plans and budgets show where gaps exist, and where new funds are needed and can be absorbed.
"These country plans show us how we can turn the tide and prevent 25 million TB deaths over the next 20 years," stated Dr Gro Harlem Brundtland, WHO Director-General. She further added, "Meeting our global targets and sustaining effective TB control effort would have an overwhelming impact: 50 million TB cases averted by 2020 and emergence of drug resistance prevented. It will also help us to reach the targets set by the G8 in Okinawa last year."
The Minister of Health of Peru, Dr E Pretell Zarate, added, "We are proud to say that Peru has reached the targets and sustained the achievements so that our TB cases are now declining at a constant rate of 8% per year. This demonstrates that DOTS has major impacts in a high-TB-problem country."
The report reveals that progress towards reaching global targets has been slow, with Peru and Viet Nam being the only high-TB-burden countries to have achieved the global targets of detection of 70% of cases with infectious TB and successful treatment of 85% of those detected. Reasons cited for slow progress include lack of political commitment; insufficient and ineffective use of financial resources; neglect of human resource development; poor health system organization and TB managerial capability; inadequate supply of anti-TB drugs; and lack of public education and information.
In response to the slow pace of progress, Dr J.W. Lee, Director of Stop TB said, "we are aware of the obstacles and these are different for each country. However, tackling TB can be done and details how to actually do this are now on the table. With the plans which clearly show the government commitment and identified needs, stopping TB can show dramatic results." Reference was made to the global discussions on new financing initiatives.