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

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2005. All rights reserved

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Over 22 million patients treated under DOTS (5 million in LCDs) with high cure rates

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60

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100

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Cas

e de

tect

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cure

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Target cure 85% Target detection 70%

Global incidence is rising largely as a resultof the epidemic in Africa (LDCs) and E. Europe

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400

1990 1995 2000 2005

Estim

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TB

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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