WHO: TB rates down, but its "global burden" remains huge

The fight against tuberculosis is making progress but "the global burden" of the deadly disease remains enormous, the World Health Organization said in its annual report Wednesday. The WHO has pledged to cut TB deaths to half the 1990 rate, a goal the agency said it was on track to achieve. And the number of new cases per capita was falling as well -- down 2.2 percent last year from 2010 and the year before. The WHO also hailed innovations in diagnostics to detect the lung disease as well as the new drugs and new vaccine possibilities advancing through development stages. But tuberculosis still sickened 8.7 million people around the world, killing 1.4 million of them, according to the 2012 report. And in Africa and Europe, mortality rates are not showing the declines seen elsewhere, and may not achieve the 50 percent drop by 2015. Asia remained the hardest hit region, with nearly 60 percent of the TB cases detected last year -- two-thirds of which were detected in China and India. A half million children under age 15 contracted TB and 64,000 died last year, the first time the WHO specified figures for children. Perhaps most worryingly, identifying and treating multi-drug-resistant tuberculosis -- around four percent of new cases and 20 percent of previously treated cases -- remains hugely challenging. Around the world, of those estimated to have the strains resistant to standard medications, only about one in five were notified. In China and India, that figure was even worse: fewer than one in 10 drug resistant cases were detected. "Major efforts are needed to improve treatment success rates among patients" with the drug-resistant strains of TB, the WHO said. Medical aid group Medicins sans Frontiers concurred, with TB advisor Grania Brigden saying the newest report "reinforces that multidrug-resistant tuberculosis is an escalating public health emergency." "Yet the global response is abysmal, with levels of testing and treatment remaining shockingly low," Brigden said, with only one in 20 patients tested. Even when diagnosed, she added, the survival rate is less than 50 percent. "We continue to struggle every day with inadequate tools and drugs to tackle the disease," which is increasing in prevalence in the places they work, she said. But Brigden said the good news is the new TB drugs "on the horizon for the first time in nearly half a century." Medical journal "The Lancet" was similarly disheartened, arguing in an editorial published to coincide with the WHO report that "insufficient attention and funding over several decades have allowed the global epidemic to remain a deep scar on the reputation of global health." "The existing control approach has taken a short-term view with heavy reliance on treatment and cure, but the health systems of many countries have simply been ill-equipped to deal with the complexities of managing tuberculosis, a fact proven by the escalating rates of multidrug-resistant and extensively drug-resistant strains of TB," it continued. While recognizing shortfalls, the WHO was nevertheless positive about the TB battle. "In the space of 17 years, 51 million people have been successfully treated and cared for according to WHO recommendations. Without that treatment, 20 million people would have died," Mario Raviglione, director of the WHO Stop TB department, said in a press release. "This milestone reflects the commitment of governments to transform the fight against TB." But the WHO said more money is needed for continued and improved progress to treat and control TB outbreaks, saying it is $3 billion short of the $8 billion necessary. And an additional $1.4 billion is required for research and development to reach the necessary $2 billion.