Africa
Road Map to Intensify Action Against TB in Africa
By Stop TB Partnership
May 4, 2005 - 6:22:00 PM

At a groundbreaking meeting of the global Stop TB Partnership today, leading African and international health and development officials unveiled a detailed "Road Map" to halt Africa's spiraling epidemic of tuberculosis, which in combination with HIV is overwhelming many health services in the region.

Describing Africa as "the battleground for reaching the global Millennium Development Goals (MDGs) for TB", the Road Map calls for establishing an African Stop TB Partnership to build greater political commitment by governments to fight the disease, and for the African Union and NEPAD to mainstream TB control into the region's health and development agenda.

The Road Map estimates that $1.1 billion will be needed in 2006-2007 to strengthen TB programmes and scale up measures to address HIV-associated TB in Africa. "More than ever before, African leadership is highly committed to health development, in particular to the triad of HIV/AIDS, tuberculosis and malaria," said Dr. Luis Gomes Sambo, the World Health Organization (WHO) Regional Director for Africa. "But more attention needs to be paid to increasing and sustaining resources to scale up field interventions if the Millennium Development Goals are to be achieved." According to WHO, TB incidence rates have tripled since 1990 in 21 African countries with high levels of HIV.

Of the 15 countries in the world with the highest TB rates today, 13 are in Africa. As a consequence, 2.4 million Africans now fall ill with tuberculosis and 540,000 people die from it every year -- a devastating toll that continues to rise by 3-4% annually. The economic toll from the disease is equally devastating. A joint report by the African Union, the Economic Commission for Africa, UNAIDS and WHO in 2004 estimated annual losses of 4-7% in Gross Domestic Product (GDP) due to TB in high burden countries.

The recent report of the Commission for Africa highlighted tuberculosis by linking TB control to strengthening health systems and called for full funding of WHO's "Two Diseases, One Patient" strategy to fight HIV-associated TB. "The challenge that TB and TB-HIV pose to African countries is enormous, and we need enormous resources in terms of funding, drugs and technical assistance to address it effectively,� said Prof. Francis Omaswa, Director General of Health in Uganda and a Stop TB Board member. "But it is equally vital that governments show leadership and commitment in order to convert these resources into effective TB treatment for the millions of African citizens who need it." Over the last decade, DOTS* programmes have diagnosed and treated millions of TB patients in Africa, and the results are actually remarkable in some countries given their levels of poverty.

A good example is Ethiopia, which has an annual Gross Domestic Product per capita of $100 and TB cure rates comparable with countries that are 30 times richer. But performance of the region's TB programmes is limited by the impact of HIV and by persistent health system constraints, especially the lack of sufficient trained health staff. In sub-Saharan Africa there is only about 1 health worker per 1,000 population, compared to a global average of 4.

The Road Map builds on the recommendations made by the African Union, UNECA, UNAIDS and WHO in their 2004 report on response to the HIV/AIDS, TB and malaria epidemics. It seeks to realize opportunities for improved regional cooperation for development through NEPAD, increased financing from various multilateral and bilateral sources, and broader engagement of patient and community activists.

Among the main elements of the road map:
� establishment of an African Stop TB Partnership to mainstream TB into the agendas of the African Union and NEPAD and strengthen health systems;
� rapid support to improve quality of TB diagnosis and treatment;
� scale up of interventions to ensure that HIV-infected persons are screened and treated for TB, and HIV-infected TB patients are among the candidates for anti-retroviral therapy;
� involvement of NGOs, private health providers and communities to expand access to TB diagnosis and treatment; and
� large-scale communication campaigns to mobilize communities, dispel stigma and increase awareness that TB treatment saves lives and can reverse the epidemic

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