Tuberculosis

The Challenge

Those least able to cope with tuberculosis (TB) are most affected - 90% of TB cases occur in the developing world.  Poor health systems and out-of-date technologies seriously hinder efforts to stop the spread of TB, or treat those already infected.  Additionally, because HIV/AIDS weakens the immune system, populations most infected by AIDS are the most susceptible to tuberculosis.  People living with AIDS die eventually because an opportunistic infection takes advantage of their weakened immune system. Tuberculosis is the most common of these opportunistic infections for those living with HIV - and a leading cause of death for people living with HIV in low- and middle-income countries.

TB is an airborne infectious disease mainly affecting the lungs.  Those who have TB bacteria in their lungs can infect others when they cough.  With the use of antibiotics, TB was thought to have been eradicated in the 1960s, but has since made a comeback due to complacent and inadequate health care systems, increased travel from areas where TB is prevalent, and the spread of HIV. Today, a new person is infected with "TB bacilli" every second - the bacteria that causes tuberculosis. The presence of this bacteria creates the potential for developing the active disease.  More than 2 billion people are currently infected with TB bacilli, and each year more than 9.2 million become sick and about 1.7 million people die from the disease (including 456,000 people who are also HIV-positive).

The evolution of the disease (along with misuse of the drugs used to treat it) has led to the development of much more drug-resistant forms of tuberculosis. Multidrug-resistant tuberculosis (MDR-TB) is difficult and expensive to treat, often failing to respond to standard first-line drugs.  MDR-TB infects nearly a half a million people each year.  Drug resistant strains of TB have turned up in 55 countries, including the United States.  More recently, an even more deadly strain of the disease has emerged, Extensively Drug Resistant Tuberculosis (XDR-TB). XDR-TB is resistant to even more of the existing tuberculosis treatment.

The Opportunity

TB is treatable.  In many endemic countries, $16-35 will buy a full six-month drug course of TB treatments and when administered using the DOTs approach (Directly Observed Therapy) which ensures adherence, success rates are high. Between 1995 and 2007, more than 37 million new and relapse cases had been treated through the DOTS approach. The "Stop TB" partnership has developed a multi-year, country-by-country strategy to fight tuberculosis. We know the cost; we have a plan; we just need quicker action and funding to implement it.

The Global Fund to Fight AIDS, Tuberculosis and Malaria has supported the detection and treatment of 5.4 million cases of infectious tuberculosis.  Despite this progress, much more remains to be done.  While funding for TB control has increased since 2002, there was a gap of $1 billion in 2008 for the 90 countries with the heaviest TB burden.