WHO Global Tuberculosis Control 2013

1. WHO Global Tuberculosis Report 2013

2. Main findings
• Burden of disease – The current global picture of TB shows
continued progress, but not fast enough
• TB detection and treatment – Millions of people access effective
TB care each year but “missed cases” hold back gains
• MDR-TB and XDR-TB – Undetected cases and treatment coverage
gaps constitute a public health crisis
• TB-HIV - TB-HIV collaborative services are expanding, but global
targets are not yet in sight
• Financing – International donor funding and more domestic
investments are essential
• Research and development – New diagnostics, medicines and
vaccines are crucial to end the global TB epidemic

3. Global burden 2012
Incident cases
Prevalent cases
Deaths
All forms of TB
8.6 million
(8.3-9.0 million)
12 million
(11-13 million)
0.94 million *
(0.79-1.1 million)
TB-HIV
1.1 Million
(1.0-1.2 million)
0.32 million
(0.30-0.34 million)
MDR-TB
0.45 million
0.17 million
* TB-HIV deaths not included
© Tong Ka Io 2013

4. Global trend of TB incidence

5. Global trend of TB prevalence

6. Global trend of TB mortality

7. Achievements of global TB control

8. Case detection rate

9. Case detection rate

10. Treatment success rate

11. Global targets
• WHA 1991
– 2000, case detection rate >70%
– 2000, cure rate >85%
• MDG
– 2015, incidence reversed
• Stop TB Partnership
– 2015, prevalence and mortality reduced by 50% compared with
1990
– 2050, incidence <1/1 million

12. Achievement of global targets
1990
2000
2005
2010
Global
48
40
42
56
66
67
WPR
36
37
39
70
80
85
China
21
32
33
74
86
89
Macao
Case detection rate
1995
2011
87
87
87
87
87
87
Cure rate
Global
40
60
77
80
80
(new ss+ cases)
WPR
67
85
89
90
91
China
72
93
92
93
94
81
93
86
86
Macao
© Tong Ka Io 2013
2012

13. Achievement of global targets
1990 1995 2000 2005 2010 2012
Incidence rate
(2012-1990)/1990
Global
147
148
148
142
128
122
-17.0%
WPR
161
138
119
105
92
87
-46.0%
China
153
129
109
92
78
73
-52.3%
Macao
110
116
120
98
85
83
-24.5%
Global
274
275
263
225
182
169
-38.3%
WPR
261
238
210
174
139
128
-51.0%
China
215
195
170
140
108
99
-54.0%
Macao
167
137
151
141
119
117
-29.9%
Mortality rate
Global
25
24
22
19
15
13
-48.0%
(excl. HIV)
WPR
21
16
12
8.6
6.4
5.8
-72.4%
China
19
13
8.7
5.7
3.8
3.2
-83.2%
Macao
10
5.4
4.6
3.3
2.8
2.8
-72.0%
Prevalence rate
© Tong Ka Io 2013

14. Countdown to 2015
On track
Off track
• Incidence rate falling in all
regions for 1 decade
• Prevalence rate fell only 37%
• AFR and EUR are not on track
• Mortality rate reduced by 45%
• 11 of 22 HBC are not on track
• AMR and WPR already
achieved 2015 targets
• 7 of 22 HBC already achieved
targets, 4 more on track
• Diagnosis and treatment of
MDR-TB is far off-track
• Targets for testing and ART for
TB/HIV have not been reached

15. Reasons of off-track
• Resource constraints
• Conflict and instability
• HIV epidemics

16. MDR-TB
Global - 320000
India – 64000
China – 59000
Russian Fed – 46000
Philippines – 13000
Pakistan – 11000
……

17. MDR-TB testing and treatment

18. XDR-TB

19. TB-HIV
Global - 1100000
South Africa – 330000
India – 130000
Mozambique – 83000
Zimbabwe - 55000
Nigeria – 46000
Kenya – 45000
Uganda – 35000
UR Tanzania – 32000
……

20. 5 priority actions
1. Reach the missed cases
2. Address MDR-TB as a public health crises
3. Accelerate the response to TB/HIV
4. Increase financing to close all resource gaps
5. Ensure rapid uptake of innovations

21. Development of TB diagnostics

22. Development of new TB drugs