who global tb control 2013

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WHO Global Tuberculosis Report 2013

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WHO Global Tuberculosis Control 2013

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WHO Global Tuberculosis Report 2013

Main findings

• Burden of disease – The current global picture of TB shows continued progress, but not fast enough

• TB detection and treatment – Millions of people access effective TB care each year but “missed cases” hold back gains

• MDR-TB and XDR-TB – Undetected cases and treatment coverage gaps constitute a public health crisis

• TB-HIV - TB-HIV collaborative services are expanding, but global targets are not yet in sight

• Financing – International donor funding and more domestic investments are essential

• Research and development – New diagnostics, medicines and vaccines are crucial to end the global TB epidemic

Global burden 2012

Incident cases Prevalent cases Deaths

All forms of TB 8.6 million (8.3-9.0 million)

12 million (11-13 million)

0.94 million * (0.79-1.1 million)

TB-HIV 1.1 Million (1.0-1.2 million)

0.32 million (0.30-0.34

million)

MDR-TB 0.45 million 0.17 million

* TB-HIV deaths not included

© Tong Ka Io 2013

Global trend of TB incidence

Global trend of TB prevalence

Global trend of TB mortality

Achievements of global TB control

Case detection rate

Case detection rate

Treatment success rate

Global targets

• WHA 1991

– 2000, case detection rate >70%

– 2000, cure rate >85%

• MDG

– 2015, incidence reversed

• Stop TB Partnership

– 2015, prevalence and mortality reduced by 50% compared with 1990

– 2050, incidence <1/1 million

Achievement of global targets

1990 1995 2000 2005 2010 2011 2012

Case detection rate Global 48 40 42 56 66 67

WPR 36 37 39 70 80 85

China 21 32 33 74 86 89

Macao 87 87 87 87 87 87

Cure rate Global 40 60 77 80 80

(new ss+ cases) WPR 67 85 89 90 91

China 72 93 92 93 94

Macao 81 93 86 86

© Tong Ka Io 2013

Achievement of global targets

1990 1995 2000 2005 2010 2012 (2012-1990)/1990

Incidence rate Global 147 148 148 142 128 122 -17.0%

WPR 161 138 119 105 92 87 -46.0%

China 153 129 109 92 78 73 -52.3%

Macao 110 116 120 98 85 83 -24.5%

Prevalence rate Global 274 275 263 225 182 169 -38.3%

WPR 261 238 210 174 139 128 -51.0%

China 215 195 170 140 108 99 -54.0%

Macao 167 137 151 141 119 117 -29.9%

Mortality rate Global 25 24 22 19 15 13 -48.0%

(excl. HIV) WPR 21 16 12 8.6 6.4 5.8 -72.4%

China 19 13 8.7 5.7 3.8 3.2 -83.2%

Macao 10 5.4 4.6 3.3 2.8 2.8 -72.0%

© Tong Ka Io 2013

Countdown to 2015

On track

• Incidence rate falling in all regions for 1 decade

• Mortality rate reduced by 45%

• AMR and WPR already achieved 2015 targets

• 7 of 22 HBC already achieved targets, 4 more on track

Off track

• Prevalence rate fell only 37%

• AFR and EUR are not on track

• 11 of 22 HBC are not on track

• Diagnosis and treatment of MDR-TB is far off-track

• Targets for testing and ART for TB/HIV have not been reached

Reasons of off-track

• Resource constraints

• Conflict and instability

• HIV epidemics

MDR-TB

Global - 320000 India – 64000 China – 59000 Russian Fed – 46000 Philippines – 13000 Pakistan – 11000 ……

MDR-TB testing and treatment

XDR-TB

TB-HIV

Global - 1100000 South Africa – 330000 India – 130000 Mozambique – 83000 Zimbabwe - 55000 Nigeria – 46000 Kenya – 45000 Uganda – 35000 UR Tanzania – 32000 ……

5 priority actions

1. Reach the missed cases

2. Address MDR-TB as a public health crises

3. Accelerate the response to TB/HIV

4. Increase financing to close all resource gaps

5. Ensure rapid uptake of innovations

Development of TB diagnostics

Development of new TB drugs