WHO rolls out new "Stop TB" initiative

By Karla Gale

NEW YORK (Reuters Health) - Although the current tuberculosis treatment strategy has helped cure nearly 20 million patients of TB, the incidence of TB continues to climb. .

March 24 is World TB Day, and to observe the occasion, this week's issue of The Lancet medical journal has a special TB focus.

TB remains the leading cause of death from a curable infectious disease, Dr. Christopher Dye, from the World Health Organization in Geneva notes. The incidence of the disease remains steady in many areas of the world, but continues to rise in Africa, secondary to the spread of HIV infection.

In response, the WHO has set new goals to reduce deaths due to TB by 50 percent in 2015 compared with the rates reported in 1990, and to eliminate TB as a public health problem by 2050, report the WHO's Dr. Mario C. Raviglione and Dr. Mukund W. Uplekar.

The authors outline the research effort needed to achieve this, including improving diagnostic testing, developing new vaccines, drugs and treatment regimens, conducting social research to reduce the risk of TB and addressing the effects of poverty.

New diagnostic tools are needed that are "sensitive, specific, rapid, cheap, safe, and field-friendly," Dr. Alimuddin Zumla and Zoe Mullan from the Royal Free and University College London Medical School advise.

Another impediment to the control of TB has been the lack of a vaccine that provides long-term protection. Several vaccines are in the pipeline, report Dr. T. Mark Doherty, from Statens Serum Institute in Copenhagen, and Dr. Graham Rook, from Royal Free and University College of Medical School in London, but there are still obstacles to overcome.

An additional stumbling block to effective treatment of TB is simultaneous HIV infection, Dr. Anthony D. Harries, of Family Health International, Malawai Country Office, Lilongwe and associates note. Treating both diseases at the same time increases the risk of adverse drug reactions and other complications.

For all this work, sufficient funding will be required. "Now it is up to developing country governments to fully commit resources to tuberculosis control, and for donors to provide catalytic financial aid...to rid the world of one of the most lethal infectious diseases in the history of humanity," Drs. Zumla and Mullan conclude.

SOURCE: Lancet, the March 18, 2006.