In its most recent assessment, a few days ago, the World Health Organisation (WHO) warned that even though fewer people fell ill and died from tuberculosis (TB) last year, countries still need to do more to bring an end to the disease by 2030. Although global efforts have averted an estimated 54 million TB deaths since 2000, TB remains the world’s deadliest infectious disease, according to the WHO.
WHO’s 2018 Global TB Report, released earlier this week, calls for an unprecedented mobilisation of national and international commitments. It urges political leaders gathering next week for the first-ever United Nations High-Level Meeting on TB to take decisive action, building on recent moves by the leaders of India, the Russian Federation, Rwanda, and South Africa. Nearly 50 Heads of State and Governments are expected to attend the meeting. Such high-level political attention and understanding of what the world needs to do to end TB is very encouraging, and it is hoped that the relevant stakeholders will use the opportunity to capitalise on this new momentum and act together to end this terrible disease.
As stated by WHO, to meet the global target of ending TB by 2030, countries need to urgently accelerate their response – including by increasing domestic and international funding to fight the disease.
The WHO report provides an overview of the status of the epidemic and the challenges and opportunities countries face in responding to it. It states that overall, TB deaths have decreased over the past year. For example, in 2017, there were 1.6 million deaths (including those of 300,000 HIV-positive people).
Globally, an estimated 10 million people developed TB in 2017. The number of new cases is falling by two per cent per year, although faster reductions have occurred in Europe (five per cent per year) and Africa (four per cent per year) between 2013 and 2017, the WHO said.
Ending the TB epidemic requires action beyond the health sector to address the risk factors and determinants of the disease. We believe that next week’s UN High-Level Meeting on TB will provide the right forum to discuss the crucial issues relating to ending TB deaths; such as the need for more financial resources and cooperation across all sectors to bring an end to the disease. Like the WHO and others, we also believe that the necessary commitments at the level of Heads of State will be essential to galvanise multi-sectoral action.
Even though Guyana still has a far way to go, this country can boast of tremendous progress made in its fight against TB; and all efforts must be made to ensure these gains are not reversed. It could be recalled that the actual number of new TB cases diagnosed by the National TB Programme (NTBP) rose steadily throughout the 90s. However, with some key interventions by the previous and present administrations, annual cases declined from 2008 and stabilised for four years thereafter due to further expansion of the Directly Observed Treatment Short course (DOTS) programme.
Based on official statistics, the case notification rate over the past five years decreased from 92 per 100,000 in 2012 to 70 per 100,000 in 2017. This is quite an achievement and kudos must be given to all the stakeholders that are working to further reduce TB cases in Guyana.
Some years ago, the DOTS system was successfully implemented in all the regions of the country and has been essential to ensuring case detection, standardised treatment, with supervision and patient support.
Ending TB will only be achieved with greater collaboration within and across governments, and with partners from civil society, communities, researchers, the Private Sector and development agencies. This means taking a whole-of-society and multidisciplinary approach, in the context of universal health coverage.
As alluded to earlier, funding also remains a crucial component. All partners can help take forward innovative approaches to ensure that everyone suffering from the disease has access to TB diagnosis, treatment and cure. Governments and Non-Governmental Organisations (NGOs) may have the best ideas to tackle TB, but it makes very little sense if there are inadequate financial resources to ensure their effective implementation.
The Public Health Ministry, along with other partners, must continue building on the gains made over the years regarding efforts to reduce TB cases in keeping with the WHO targets.
