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Session 11: MDR & XDR-TB: How Can Business Help Stem the Tide?

Session 11: MDR & XDR-TB: How Can Business Help Stem the Tide? Overview of Global MDR-TB/XDR-TB Issues & Bottlenecks to Fighting the Epidemic Ernesto Jaramillo WHO/Stop TB Department. Definitions of TB, MDR-TB, XDR-TB. Source of data: - TB: best performing NTP from HBCs

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Session 11: MDR & XDR-TB: How Can Business Help Stem the Tide?

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  1. Session 11: MDR & XDR-TB: How Can Business Help Stem the Tide? Overview of Global MDR-TB/XDR-TB Issues & Bottlenecks to Fighting the Epidemic Ernesto Jaramillo WHO/Stop TB Department

  2. Definitions of TB, MDR-TB, XDR-TB Source of data: - TB: best performing NTP from HBCs - MDR-TB: average from GLC-approved sites - XDR-TB: well performing MDR-TB treatment programme in absence of HIV

  3. The global burden of TB in 2008 Estimated number of cases Estimated number of deaths All forms of TB 1.3 million* 9.37 million HIV-associated TB 0.52 million 1.4 million (15%) Multidrug-resistant TB (MDR-TB) 440,000 >150,000 *excluding deaths among HIV+ people

  4. TB 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

  5. M/XDR-TB 2010 global report on surveillance and response • Detection & Diagnosis • Only 7% of all estimated; US$87 million EXPAND-TB project scaling-up access in 27 countries • Treatment Success • 60% ! • Country response • 20/27 high MDR-TB countries strengthening MDR-TB components of TB control national plans

  6. New MDR-TB cases 50 40 30 Cases notified 20 10 0 1994 1996 1998 2000 2002 2004 2006 2008 Year New MDR-TB cases 100 80 60 Cases notified 40 20 0 1994 1996 1998 2000 2002 2004 2006 2008 Year Trends of MDR-TB cases in selected settings Tomsk Oblast, Russian Federation Orel Oblast, Russian Federation

  7. MDR-TB epidemic: Global challenge No treatment reported. Some treatment probably obtained, quality unknown 440,000 estimated cases in 2008 Countries report treatment, standard unknown (7%, including GLC programmes) 7% 3% Treated in GLC approved programmes

  8. 27 high MDR-TB burden countries Progress of MDR-TB care very slow Global Plan* To reach targets, scale-up required in India, China and Russian Federation in particular Actual or expected progress *Based on Global MDR/XDR-TB Response Plan, 2007, updated for high-level Ministerial meeting on MDR/XDR-TB in Beijing, April 2009

  9. We have political commitment from national governments

  10. High-level policy changes are fundamental! World Health Assembly, May 2009… In addition to high quality DOTS... • Remove financial barriers (UHC) • Ensure well trained and sufficient human resources • Establish a network of labs where rapid tests are also available • Ensure availability of quality drugs • Regulate the use of all anti-TB drugs • Introduce infection control • Establish proper surveillance • Promote Research & Development • Address social determinants and risk factors • Mobilize resources domestically and internationally Document WHA 62.15, 2009

  11. Countries, WHO and the Stop TB Partnership have strong partners, but…

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