The following are
remarks by Kent Hill, USAID Assistant Administrator for Global Health, on
the observance of World Tuberculosis Day 2008:
Although a cure for Tuberculosis (TB) has existed for more than half a
century, TB remains one of three leading causes of death worldwide due to
infectious disease. TB kills approximately 1.6 million people each year,
while HIV/AIDS claims more than two million lives each year, and malaria
kills more than one million people each year.
The U.S. Agency for International Development (USAID) has a clear and
proven strategy to detect and treat people who suffer from TB. We are
helping to make progress in prevention and control, and in 2005, the rate
of new TB cases worldwide leveled off for the first time since the World
Health Organization (WHO) began collecting data about the disease.
Globally, the target of successfully treating 85 percent of TB cases has
been met, and we continue to make steady progress toward the target of
detecting 70 percent of all cases.
USAID is the lead U.S. government agency in international TB control
programs, supporting efforts in 37 countries. USAID works in close
partnership with the President's Emergency Plan for HIV/AIDS Relief, which
is making significant investments in TB and HIV co-infection, with the
Centers for Disease Control and Prevention, and with the National
Institutes for Health.
The core of USAID's work in TB is focused on building the capacity of
developing countries to implement effective programs to combat and control
TB. Our programs support the implementation of the WHO Global Plan to Stop
TB, which works to expand and strengthen basic TB programs as the key
intervention for preventing and controlling drug-resistant TB. USAID is a
founding member of the Stop TB partnership, which is comprised of a network
of more than 500 international organizations, countries, donors from the
public and private sectors, and nongovernmental and governmental
organizations. Working closely with our partners, USAID recently increased
the capacity to deliver Directly Observed Short Course (DOTS) treatment in
more than 40 countries, including hard hit countries such as India,
Indonesia, South Africa, and Russia
Our efforts are saving lives and making a real difference in affected
communities, but much work remains to be done. The best approach we have to
diagnose TB in resource limited settings is more than 100 years old, and
the approach is only effective half of the time, even less so in HIV
positive patients where TB is deadliest.
In addition, Eastern Europe and Asia are fighting an increasing
prevalence of multiple drug resistance (MDR) to proven drug therapies.
According to a new WHO report, MDR-TB rates are at their highest ever.
MDR-TB requires treatment for 18 to 24 months with second-line drugs that
are much less effective, poorly tolerated by the patient, and far more
costly. Nearly 500,000 new cases of MDR-TB emerged globally in 2006.
Extensively drug-resistant (XDR) TB, a subset of MDR-TB caused by
bacteria strains that are resistant to first-line and the most effective
second-line drugs, has been recorded in 45 countries. XDR-TB is a virtually
untreatable form of the respiratory disease. The true scale of the problem
remains almost unknown because few countries are equipped to diagnose it.
Africa has the highest incidence of TB in the world, and Sub-Saharan
Africa is battling the combined effects of TB and HIV/AIDS. TB is the
leading cause of death for AIDS patients. In parts of Sub-Saharan Africa,
rates of HIV co-infection among TB patients often exceed 50 percent.
The recent WHO report finds that some countries are making strides
against the TB/HIV co-epidemic. Almost 700,000 TB patients were tested for
HIV in 2006, up from 22,000 in 2002.
In addition to our work to strengthen basic TB programs, USAID has
moved quickly to help countries and international partners respond to these
new threats by assisting with drug-resistance surveys, building laboratory
capacity to detect resistant strains, expanding country-level programs to
treat MDR-TB patients, and supporting the Green Light Committee, which
helps ensure that countries have effective programs to manage MDR-TB
patients and second-line anti-TB drugs.
The threats of MDR-TB and XDR-TB have re-focused attention on the
urgent need to develop more accurate and rapid diagnostics for TB, to
develop new drugs effective against resistant strains, and to develop an
effective TB vaccine. The U.S. is committed to work with country
governments and the international community to successfully implement the
WHO Global Plan to Stop TB. Together, we can continue to bring hope to the
millions of people suffering from TB and work toward curing TB once and for
all.
For more information on USAID's Global Health programs, please visit
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U.S. Agency for International Development
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