Tuberculosis effort in real danger – WHO

By James Gallagher Health and science reporter, BBC News

Tuberculosis There were 1.4 million deaths from tuberculosis in 2011.

The international effort to eliminate tuberculosis is “in real danger”, according to the World Health Organization (WHO).

Its latest figures showed there were 8.7 million new cases in 2011 and 1.4 million deaths.

It warned of “persistently slow progress” in treating tuberculosis which is resistant to antibiotics.

The TB Alliance said resistant tuberculosis was one of the most “ominous global health threats”.

Tuberculosis is a bacterial infection that mainly affects the lungs but can be found elsewhere in the body.

Dr Mario Raviglione, from the WHO, said that more 20 million lives had been saved in the past 17 years as a result of international commitments to tackle tuberculosis.

However, he warned: “The momentum to break this disease is in real danger.

“We are now at a crossroads between TB elimination within our lifetime, and millions more TB deaths.”

The WHO said there was a massive funding gap for treating the disease in low- and middle-income countries which “threatens to hold back” care.

It said £5bn was needed between 2013-2015, but there was a funding gap of £2bn.

Tuberculosis symptoms

  • A persistent cough, usually for more than three weeks
  • Night sweats for weeks or months
  • Weight loss
  • Fatigue
  • High temperature
  • Shortness of breath

Resistance

The report also highlighted problems treating people with multi-drug resistant tuberculosis. It said only a fifth of patients thought to have the version of the disease had actually been diagnosed.

The TB Alliance said: “Tuberculosis continues to kill more than 1.4 million people every year and drug-resistant TB remains one of the world’s most ominous global health threats, but treatments for this disease are antiquated and inadequate.

“Standard treatments for drug sensitive tuberculosis must be taken every day for as long as six months to ensure that all bacteria in the patient are eradicated.

“Drug-resistant TB requires a minimum of 18 months of treatment, which includes more toxic drugs and injections.”

Vaccines

Many researchers say that new vaccines will be the only long-term solution to tuberculosis.

The BCG vaccine is 90 years old. It is very effective at preventing severe TB, such as TB meningitis, in children. However, it is less effective at preventing TB in the lungs, which is where adults and teenagers tends to be infected.

Dr Ann Ginsberg, vice-president of Aeras, an organisation working on vaccines, said tuberculosis was “truly raging” in some parts of the world where “all aspects of society are touched” by the disease.

She added: “If we really want to control this epidemic we need safe, affordable vaccines – but it’s a very complex disease and may require multiple vaccines.”

Dr Ginsberg said it was “going to be a slog”, but that progress had been made in the past decade with researchers going from no new vaccines in the pipeline to having 12 being tested.

The first clues to the effectiveness of the new wave of vaccines are expected in the next year when the trial data from a vaccine developed at the University of Oxford is completed.

Prof Helen McShane has developed the MVA85A vaccine which has been given to nearly 3,000 babies in Africa.

She said: “If it proves effective, it would be a hugely exciting result.”

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