World TB day 2016 - March 24th

Published:

Themes:

  • Global Stop TB Partnership: Unite to End TB
  • European Centre for Disease Prevention and Control/WHO Europe: Focus on TB in the most vulnerable populations

Background
World TB day is held every year on March 24th with the aim of raising awareness about TB among both health professionals and the public, and to support global efforts to prevent and control TB.

World TB day commemorates the day in 1882 when Dr Robert Koch announced that he had discovered the cause of tuberculosis, the TB bacillus. This was a major step in the understanding of the disease which killed millions of people throughout Europe and the rest of the world at that time.

Although great strides have been made in the prevention and control of TB in recent years, TB remains one of the biggest infectious disease killers worldwide: in 2014, 9.6 million people fell ill with TB and 1.5 million died, including 140,000 children1.

TB remains primarily a disease of poverty: more than 95% of cases of TB occur in the developing world as do the majority of deaths.

Drug resistance is also a major challenge. The World Health Organization (WHO) estimates that 480,000 people have drug-resistant TB worldwide. Patients with multidrug-resistant TB (MDR-TB) and extensively-drug resistant TB (XDR-TB) face much longer treatment, take more drugs, suffer from more side effects and treatment costs are five times higher compared to those with drug-susceptible TB.

Theme of World TB Day 2016-Stop TB Partnership
For 2016, the global Stop TB Partnership chose the theme “Unite to end TB”. The Stop TB partnership is using the symbol of a red arrow to represent the global solidarity to a world without TB.

The arrow represents the unwavering commitment to move forward until we reach the finish line to End TB.

The Global Plan to End TB 2016-2020
The theme to “Unite to End TB” coincides with the publishing of the Global Plan to End TB 2016-2020 by the Stop TB Partnership2. The plan is a roadmap to accelerating the end of the global TB epidemic and reaching the targets of the WHO End TB Strategy. The aim of the plan is to highlight the need to shift the paradigm from barely controlling the epidemic to ending it altogether. This plan includes chapters on the following aspects of improving TB prevention and control globally:

  • The development of new diagnostics and of new drugs for the treatment of TB
  • Recommendations on improving the involvement of communities in the fight against TB
  • Ways of reaching target populations who are most at risk of contracting TB and
  • Calls for providing universal health coverage so that diagnosis and treatment of TB is more accessible to those who most need it.

It calls for the integration of TB into poverty alleviation and social justice programmes.

Global Plan Targets
The Global Plan outlines a set of three new, ambitious targets– 90-(90)-90 –to aggressively scale up efforts to end TB. The 90-(90)-90 target aims to:

  1. Reach 90% of all people with TB and place all of them on appropriate therapy— first-line, second-line and preventive therapy as required
  2. Reach at least 90% of key populations-the most vulnerable, underserved, at-risk populations
  3. Achieve at least 90% treatment success rate for all people diagnosed with TB through affordable treatment services, adherence to complete and correct treatment, and social support.

These targets put the focus where it matters the most: on people with TB. Of the nearly 10 million individuals worldwide who get sick with TB each year, nearly four million people are consistently missed by health systems. They do not receive effective treatment and can infect up to 15 people among their children, families and community each year. Finding and treating all of them is essential if we are to bring about the unprecedented rate of decline in TB that has not been seen since the Second World War, but will be necessary to end the disease. See also http://www.stoptb.org/assets/documents/global/plan/plan2/ExecutiveSummary.pdf

European Centre for Disease Prevention and Control/WHO Europe-World TB Day 2016
The European Centre for Disease Prevention and Control (ECDC) and WHO Europe have focused on the most vulnerable populations for World TB Day 2016 i.e. the homeless, drug and alcohol abusers and migrants from countries with high numbers of cases of TB. New data released by ECDC and WHO/Europe ahead of World TB Day on March 24th show that an estimated 340,000 Europeans had TB in 2014, corresponding to a rate of 37 cases per 100,000 population.

With new TB cases decreasing in Europe by 4.3% on average between 2010 and 2014, the WHO European Region has met the Millennium Development Goal target of reversing the incidence of TB by 2015. However, high rates of multidrug-resistant (MDR) TB and of TB in the vulnerable populations outlined above continue to challenge TB elimination. These vulnerable groups are at higher risk of MDR-TB and because of their living conditions, TB is often diagnosed late and it is harder for them to complete treatment.

ECDC state that while tuberculosis is a persistent public health threat, specific action can be taken that could lead to TB elimination by 2050. In Europe, most countries have low TB rates. The disease tends to concentrate among the marginalised, the poorest and most vulnerable groups. Interventions designed to address those groups would prevent people from catching and transmitting the disease. This would also reduce the risk to spread variants of TB e.g. MDR-TB and XDR-TB that are more difficult to treat.

To help EU/EEA countries in designing specific interventions, ECDC is launching several materials:

  • Guidance on tuberculosis control in vulnerable and hard-to-reach populations;
  • Policy Briefing: Interventions in vulnerable groups are the key to eliminating tuberculosis in Europe;
  • Examples of TB interventions and personal stories of their beneficiaries.

Together with WHO Europe, ECDC released the latest data on TB in Europe in the Annual surveillance report.
- See more at http://ecdc.europa.eu/en/healthtopics/Tuberculosis/world-tb-day/Pages/World-TB-Day-2016.aspx

See also ECDC/WHO Europe press statement for World TB Day 2016

Epidemiology of TB in Ireland
The incidence of TB in Ireland has been declining, however more than 300 cases of TB were diagnosed in 2015. Over the last 10 years, the number of cases of TB decreased from 450 in 2005 to 318 cases in 2015 with the crude incidence declining from 10.6 /100,000 population in 2005 to 6.9/100,000 in 2015. In 2015, the incidence in foreign-born persons was 16.5/100,000, while in Irish-born it was 4.1/100,000. For more information on TB in Ireland see HPSC: http://www.hpsc.ie/A-Z/VaccinePreventable/TuberculosisTB/

For more information on TB worldwide see
Stop TB Partnership: http://www.stoptb.org/ and http://www.stoptb.org/events/world_tb_day/2016/default.asp
Centers for Disease Control and Prevention USA: http://www.cdc.gov/tb/ and http://www.cdc.gov/tb/worldtbday/
European Centres for Disease Prevention and Control: http://ecdc.europa.eu/en/healthtopics/Tuberculosis/world-tb-day/Pages/World-TB-Day-2016.aspx
World Health Organization: http://www.euro.who.int/en/health-topics/communicable-diseases/tuberculosis and http://www.who.int/topics/tuberculosis/en/
WHO Europe: World TB Day 2016: Focus on the most vulnerable populations
Public Health England: https://www.gov.uk/government/collections/tuberculosis-and-other-mycobacterial-diseases-diagnosis-screening-management-and-data

References:
1. World Health Organization: Tuberculosis. Factsheet No 104. Available from: http://www.who.int/mediacentre/factsheets/fs104/en/

2. The Stop TB Partnership: Global Plan to End TB 2016 – 2020. Available from: http://www.stoptb.org/global/plan/plan2/ [Accessed 19th February 2016].

3. Health Protection Surveillance Centre. Tuberculosis. Available from:http://www.hpsc.ie/A-Z/VaccinePreventable/TuberculosisTB/Epidemiology/ [Accessed 23rd February 2016].

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