MANILA, 15 NOVEMBER 2012 - The World Health Organization Western Pacific Region — home to more than one fourth of the world's population — is on track to achieve the Millennium Development Goal (MDG) target to halve the tuberculosis (TB) epidemic by 2015.
According to the WHO Global Tuberculosis Report 2012, TB deaths in the Region decreased from an estimated 21 per 100 000 of population in 1990 to 6.9 per 100 000 of population in 2011. Over the same period, the number of people with TB decreased from 255 per 100 000 of population to 138 per 100 000 of population. In addition, the number of people who acquired TB decreased from 159 per 100 000 of population in 1990 to 92 per 100 000 of population in 2011.
"These milestones validate the strong efforts made by governments and dedicated health workers whose diligence, dedication and proficiency have saved millions of lives," says Dr Shin Young-soo, WHO Regional Director for the Western Pacific. However, he cautions against complacency, emphasizing that "countries need to strengthen their health systems to prevent the development and spread of TB, especially multidrug-resistant TB (MDR-TB)."
Of the 22 high-burden countries that account for more than 80% of the world's TB cases, four are in the Western Pacific: Cambodia, China, the Philippines and Viet Nam. Together, these four account for 93% of the cases in the Region.
TB deaths and the number of people with TB are falling in these countries. Since 1990, Cambodia has seen a 59% decrease in TB deaths and a 51% decrease in the number of people with TB. Over the same period, China's TB deaths decreased by 81%, while the number of Chinese with TB decreased by 52%. In the Philippines, TB deaths decreased by 49% while the number of Filipinos with TB decreased by 52%. In Viet Nam, TB deaths decreased by 27% while the number of Vietnamese who have TB decreased by 20% since 1990.
The report highlights the success of Cambodia. Twenty years ago, the country had one of the world's highest TB rates and a health system weakened by decades of conflict and economic hardship. Over the past decade, universal access to TB care through primary health centres has halved the number of new cases and helped Cambodia meet global targets for detection and treatment.
At the core of Cambodia's approach was the WHO-recommended Directly Observed Therapy – Short Course (DOTS) strategy, with its emphasis on supporting TB patients as they follow a six-month treatment regimen. The strategy is a five-component package comprising political commitment, diagnosis using sputum smear microscopy, a regular supply of first-line anti-TB drugs, short-course chemotherapy and a system for recording the number of cases detected by national TB control programmes and the outcomes of treatment.
Between 1995 and 2011, 51 million people worldwide were successfully treated for TB in countries that had adopted this strategy, saving an estimated 20 million lives. The number of community-based health centres providing free, DOTS-based TB services in Cambodia surged from 60 in 2000 to around 1000 in 2005. Over the same period, the number of health workers trained in TB control increased from 800 to 2500. By 2005, Cambodia had achieved the global TB targets of a 70% case detection rate and 85% treatment success.
MDR-TB continues to be a threat. MDR-TB is TB that does not respond to at least isoniazid and rifampicin, the two most powerful tuberculosis drugs. The primary cause of multidrug resistance is mismanagement of TB treatment. Most people with TB are cured by strictly following a six-month drug regimen with support and supervision. Inappropriate or incorrect use of antimicrobial drugs, or use of ineffective formulations of drugs, can cause drug resistance. Each year, more MDR-TB cases are being reported. In the Region, an estimated 68 000 people were afflicted with MDR-TB in 2011.
TB is an infectious bacterial disease that most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.
In healthy people, infection often causes no symptoms, since the person's immune system acts to "wall off" the bacteria. The symptoms of active TB of the lungs are coughing, sometimes with sputum or blood, chest pains, weakness, weight loss, fever and night sweats. Tuberculosis is treatable with a six-month course of antibiotics.
For more information, please contact
Dr Catharina van Weezenbeek
Team Leader, Stop TB and Leprosy
Tel: +63 2 5289701
Email: vanweezenbeekc@wpro.who.int
Ms Marilu Lingad
Assistant, Public Information Office
Tel: +63 2 5289993
Email: lingadm@wpro.who.int