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WHO Says It Has Exceeded Goal On Tuberculosis Cure

Twenty-two "high-burden" countries, including Russia, are responsible for 80 percent of the total number of tuberculosis cases.
Twenty-two "high-burden" countries, including Russia, are responsible for 80 percent of the total number of tuberculosis cases.
WASHINGTON -- The World Health Organization says that in the past 15 years, about 36 million people have been cured of tuberculosis, or TB, and 8 million deaths have been prevented under a strict medical regime it introduced more than a decade ago.

The WHO reports that, in the most recent 12-month period for which data is available, doctors following the organization's guidelines exceeded the targeted cure rate in their patients.

Dr. Mario Raviglione, the director of the WHO's Stop TB department, calls that "very good news."

"It's the first time ever that we've actually now surpassed the 85 percent, announcing an 87 percent [cure rate] worldwide," Raviglione says. "So that makes us feel very comfortable and effectively makes us say that we have a program here [that] effectively cures people in the millions when [the program's procedures] are implemented properly."

Raviglione and his associates announced the promising results at a news conference at the U.S. Capitol in Washington on December 8.

But in an interview with RFE/RL, he said he wishes the news was even better.

"The expectation was that the incidence of TB would start coming down by 6 to 10 percent per year, which would have allowed us to foresee elimination [of the disease] in the next 50 or 70 years," Raviglione says. "What is happening now [is] we are achieving high performance in [our] programs with this 87 percent. The detection has increased, but is not yet satisfactory. So we don't detect roughly a third of the patients of tuberculosis."

Russia's 'Burden'

Raviglione says the TB problem is especially difficult in Russia, Central Asia, and countries in Eastern Europe such as Belarus, Romania, and Ukraine.

Russia, in particular, is a major concern for the health organization.

"Twenty-two 'high-burden' countries are responsible for 80 percent of the total number of cases of TB," he says. "Among those, there is one European country, and that is Russia, with a total of 128,000 cases. We estimate 10,000 people dying of tuberculosis every year."

Russia is the only European country among the 22 so-called "highest-burden" countries in the group's report.

Some Eastern European countries are faring no better, Raviglione says. Belarus and particularly Ukraine are strongly affected.

He says in Central Asia, the situation isn't much better, with TB causing widespread infection and high mortality. Even worse, it has become resistant to many drugs.

Central Europe, however, is a relative bright spot. Raviglione says in the Czech Republic, Slovakia, Poland, and the Balkans, the rate of TB infection is much lower than in Russia and Central Asia. In fact, he calls the Czech and Slovak TB programs among the best in the world.

What separates success from failure, he says, is how quickly former communist states adapted to Western-style economies so they could afford to be vigilant about stopping the spread of the disease and cure it when it strikes.

Money is the main problem in countries where TB is a persistent problem. The WHO estimates that it costs as much as $6 billion a year to fight the disease worldwide. But only about two-thirds of that amount is available in any given year.

In former communist countries that were slow to reform their economies, Raviglione says, TB spread easily and quickly.

"So you had a situation there where poverty was growing, where the capacity of the health system to react was minimized, where drugs were often not available, and you have alcohol and [tobacco]," Raviglione says. "And you have therefore [people] in poverty anyway, and nutrition which is [negatively] altered by all this, and you have exactly the recipe for a disaster in terms of TB control."

The WHO's overall strategy in its fight against TB includes government financing, increasing the accuracy of diagnoses, carefully supervised treatment along WHO guidelines, a supply of effective drugs, and a mechanism under which doctors and the WHO can monitor and evaluate progress in treatment.

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