WHO and ERS to eliminate TB in 33 countries
The World Health Organization (WHO) and the European Respiratory Society (ERS) have come up with a new framework to eliminate tuberculosis in countries with “low levels” of tuberculosis (TB).
In a joint statement, the two organizations said there are 33 countries and territories now where there are fewer than 100 TB cases per million population.
These are Australia, Austria, Bahamas, Belgium, Canada, Costa Rica, Cuba, Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Jamaica, Jordan, Luxembourg, Malta, Netherlands, New Zealand, Norway, Puerto Rico, Slovakia, Slovenia, Sweden, Switzerland, United Arab Emirates, United States of America, West Bank and Gaza Strip.
Pre-elimination phase
The framework, which outlines an initial “pre-elimination” phase, was aimed to achieve this goal by 2035. And by 2050, the target is to achieve full elimination of the disease by having less than 1 case per million people per year.
“Although TB is preventable and curable, in these 33 settings 155,000 people still fall ill each year and 10,000 die. Millions are infected and at risk of falling ill,” the statement showed.
The proposed framework builds on approaches that are already proving successful.
It was developed with experts from low-burden countries and adapted from the new WHO global TB strategy, 201635, approved by the World Health Assembly in May 2014.
Country representatives gathered to discuss the framework and its implementation at a meeting co-hosted by WHO and the European Respiratory Society (ERS) in Rome in collaboration with the Italian Ministry of Health. Italy is one of the 21 European countries addressed by the framework.
The 33 countries, territories and areas also include seven from the Americas, three from WHO’s Eastern Mediterranean Region, and two from WHO’s Western Pacific Region.
The countries recognize the common need to reenergize the efforts to eliminate TB as a public health problem and prevent its resurgence.
As TB rates have fallen in many of these countries, attention to this public health threat has waned and capacity to respond could be weakened.
According to WHO Assistant Director General Hiroki Nakatani, “low TB-burden countries already have the means to drive down TB cases dramatically by 2035.”
Smart TB interventions
“Universal health coverage, which ensures everyone has access to the health services they need without suffering financial hardship as a result, is the bedrock. The key is to target smart TB interventions towards the people who need them most,” Nakatani added.
The new WHO framework highlights the effectiveness of eight key interventions, in a coherent package for impact in the target countries.
The framework was designed to address most vulnerable and hard-to-reach groups and the special needs of migrants; cross-border issues; undertake screening for active TB and latent TB infection in high-risk groups and provide appropriate treatment; manage outbreaks and optimize multi-drug resistant-TB prevention and care, among others.
Barriers in accessing health services
Among the most vulnerable groups are people who are poor or homeless, migrants, and members of ethnic minorities.
Others are the people who use drugs or are incarcerated, and people with compromised immune systems like those infected with HIV, malnourished with diabetes, smokers and heavy drinkers. They all have “much greater risk of falling ill with TB.”
The statement showed that many of these vulnerable groups face barriers in accessing health services.
Addressing tuberculosis in the context of crossborder migration can also pose a significant challenge to health service providers.
Many undergoing a course of TB treatment may have no option but to relocate for work, even if they have not completed their TB treatment,” the statement reads.
The two agencies said that globalization and increased population movements enable TB — an airborne infectious disease — to continue to spread across communities and countries.
To eliminate the disease in low-burden countries, they claimed, “it will be vital to dramatically scale up TB prevention and care in high-incidence countries.”
“This interdependency calls for concerted action and tight collaboration between countries with high and low burden of TB,” they added.