1 / 28

Progress towards global targets for TB control

Progress towards global targets for TB control. Katherine Floyd Stop TB Department World Health Organization IUATLD conference Stop TB Symposium Cancun, 3 December 2009. To be published on 8 December. Overview. The global burden of TB (2008) and global targets for TB control

artie
Download Presentation

Progress towards global targets for TB control

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Progress towards global targets for TB control Katherine Floyd Stop TB Department World Health Organization IUATLD conference Stop TB Symposium Cancun, 3 December 2009

  2. To be published on 8 December

  3. Overview • The global burden of TB (2008) and global targets for TB control • Progress towards global targets • Treatment success and case detection • TB/HIV and MDR-TB • Financing • Disease burden – incidence, prevalence, mortality • Summary

  4. The global burden of TB and global targets for TB control

  5. The global burden of TB in 2008 Estimated number of cases Estimated number of deaths 9.4 million (range, 8.9–9.9 million) 1.3 million* (range, 1.1–1.7 million) All forms of TB 1.4 million (15%) (range, 1.3–1.6 million) 0.52 million (range, 0.45–0.62 million) HIV-associated TB Multidrug-resistant TB (MDR-TB) *excluding deaths among HIV+ people 0.5 million

  6. Americas EMR 3% 7% South- Europe East Asia 5% 34% Africa 31% Western Pacific 20% Most cases still in Asia 54% cases in Asia

  7. Highest incidence rates in Africa Linked to high rates of HIV infection: 78% of estimated HIV+ TB cases in Africa

  8. Global targets for reductions in disease burden set for 2015 • Millennium Development Goals • Halt and reverse incidence (MDG 6, Target 6.c) • Stop TB Partnership • Halve 1990 prevalence and mortality rates (per 100 000 population)

  9. Major targets in the Global Plan • Detect 84% of smear-positive cases, and successfully treat 87% of them, by 2015 • TB/HIV • 85% TB patients tested for HIV by 2010 • 95% HIV+ TB patients on CPT* by 2010 • 320,000 HIV+ TB patients enrolled on ART* by 2010 • MDR-TB • 80% of smear and/or culture-positive cases diagnosed and treated by 2015 (equivalent to ~400,000 cases in 2015) • Financing • US$5–9 billion per year for TB control, 2009–2015 *CPT, cotrimoxazole preventive therapy; ART, antiretroviral therapy

  10. 2. Progress towards global targets a) treatment success and case detection rates

  11. Treatment success target reached globally Successful treatment rate (%) in DOTS cohorts But not in the Americas, Africa and Europe

  12. Case detection stagnating globally, gap with Global Plan widening 90 80 70 60 50 40 30 90 80 70 60 50 40 30 90 80 70 60 50 40 30 Africa-high HIV Africa-low HIV Eastern Europe Gap especially large in Africa Case detection rate (%) Eastern Mediterranean Latin America South-East Asia Three regions ahead or on track compared with Global Plan GLOBAL Western Pacific 5.7 million notified cases X.X million sm+ notified cases Red line: Global Plan milestones and 2015 target for CDR Black line: actual CDR 61% in 2008 vs. Global Plan milestone of 71% CDR stable at ~70% since 2005 2002 2008 2015 2002 2008 2015 2002 2008 2015

  13. Estimated case detection rates in 2008, by region Case detection rate (%) EMR = Eastern Mediterranean Region

  14. 2. Progress towards global targets b) TB/HIV and MDR-TB

  15. 240 700 200 600 500 160 400 120 300 80 200 40 100 0 2005 2006 2007 2008 2005 2006 2007 2008 100 80 60 Thousands 40 20 2005 2006 2007 2008 TB/HIV intervention scale-up, Africa* TB patients tested for HIV HIV+ TB patients on CPT 73% 45% Thousands Thousands 11% HIV+ TB patients on ART 31% *Africa has 78% HIV+ TB cases globally

  16. 70 non-GLC 55 60 GLC-approved 50 37 40 30 29 Number of patients (thousands) 30 23 19 20 10 0 2005 2006 2007 2008 2009 2010 MDR-TB treatment expected to expand from currently low levels in 2009 and 2010 GLC = Green Light Committee

  17. But still behind Global Plan* in 27 high MDR-TB burden countries Global Plan To reach targets, scale-up required in India, China and Russian Federation in particular Actual or expected progress *Global MDR/XDR-TB Response Plan, 2007, updated for high-level Ministerial meeting on MDR/XDR-TB in Beijing, April 2009

  18. 2. Progress towards global targets c) financing

  19. Funding has increased substantially in recent years 4.1 2.7 Data based on ~ 100 countries each year with ~ 94% estimated global cases technical assistance and R & D not included

  20. But still falls short of Global Plan targets, except in E. Europe All regions except Eastern Europe Eastern Europe 3.8 GP = Global Plan AF = Available Funding US$ billions 2.7 2.2 1.7 1.3 1.2 Data based on ~ 100 countries each year with ~ 94% estimated global cases Sources: WHO TB database, Global Plan; technical assistance and R & D not included

  21. 2. Progress towards global targets d) impact targets for reductions in disease burden

  22. Incidence rates falling globally after peak in 2004 1990 1995 2000 2005 Peak in 2004 150 Rate per 100,000 population 145 140 135 130 World as a whole on track to achieve MDG target 6.c 125 120

  23. Incidence rates in 9 subregions Africa-high HIV Africa-low HIV Central Europe Rate per 100,000 population Incidence falling in all sub-regions except African countries with low HIV prevalence Eastern Europe EME* E. Mediterranean Latin America South-East Asia W. Pacific *EME = Established Market Economies

  24. Prevalence rates in 9 subregions 700 400 120 600 100 350 500 80 300 400 60 250 300 40 200 200 20 250 40 400 35 350 200 30 300 25 250 150 20 200 15 150 100 10 100 400 160 500 350 140 300 400 120 250 100 300 200 80 150 60 200 40 100 1990 1995 2000 2005 1990 1995 2000 2005 1990 1995 2000 2005 Africa-high HIV Africa-low HIV Central Europe Five regions appear to have reached target of halving 1990 prevalence rate already (green) Rate per 100,000 population EME* E. Mediterranean Eastern Europe SE Asia and E. Mediterranean may be able to achieve target Latin America South-East Asia W. Pacific African countries far from target, such that target unlikely to be reached globally *EME = Established Market Economies Black linemarks target level at 50% of 1990 prevalence rate

  25. Mortality rates in 9 subregions 55 14 100 50 12 80 45 10 40 60 8 35 6 30 40 25 4 20 20 2 40 100 2.5 35 80 30 2.0 60 25 1.5 40 20 1.0 20 15 60 70 20 60 50 50 15 40 40 10 30 30 20 5 20 1990 1995 2000 2005 1990 1995 2000 2005 1990 1995 2000 2005 Africa-high HIV Africa-low HIV Central Europe Four regions appear to have reached target of halving 1990 mortality rate already (green) Rate per 100,000 population EME* Eastern Europe E. Mediterranean SE Asia, E. Mediterranean and E. Europe may be able to achieve target Latin America South-East Asia W. Pacific African countries far from target, such that target unlikely to be reached globally *EME = Established Market Economies Black linemarks target level at 50% of 1990 mortality rate

  26. Summary of progress towards targets

  27. Acknowledgements all those from 198 countries that contributed to reporting of data to WHO in 2009 (www.stoptb.org/tme) Core Report Team Léopold Blanc, Dennis Falzon Christopher Fitzpatrick, Katherine Floyd, Inés Garcia, Philippe Glaziou, Christian Gunneberg, Tom Hiatt, Hazim Timimi, Mukund Uplekar, Lana Velebit WHO Regional Offices Amal Bassili, Andrei Dadu, Daniel Kibuga Khurshid Hyder, Rafael Lopez-Olarte Daniel Sagebiel, Henriette Wembanyama USAID

  28. To be published on 8 December

More Related