Though the number of tuberculosis-related death continues to decline each year in developed countries, it still poses a risk, especially to the immune-compromised section of the society. But with increased awareness and strategies, it can be completely eliminated, according to the World Health Organization (WHO), which Thursday unveiled a new framework to eradicate TB in countries with low levels of the diseases.
"Low TB-burden countries already have the means to drive down TB cases dramatically by 2035," said Dr. Hiroki Nakatani, WHO assistant director-general, in a press release. "Universal health coverage, which ensures everyone has access to the health services they need without suffering financial hardship as a result, is the bedrock. The key is to target smart TB interventions towards the people who need them most."
The framework, developed in collaboration with the European Respiratory Society (ERS) is targeted toward eliminating TB in 33 countries and territories, including Australia, Austria, France, Germany, Greece, Italy, and the United States, where there are fewer than 100 TB cases per million population.
The framework outlines an initial “pre-elimination” phase, the aim of which is to reduce the incidences of TB to fewer than 10 new cases per year by 2035 in these countries. By 2050, the goal is to achieve full elimination defined as less than one case per million people per year.
Many of the approaches suggested by the new framework have already proven successful in low-income regions of the world. The new framework was developed by experts from these regions and adapted from the new WHO global TB strategy, 2016-35, approved by the World Health Assembly in May 2014.
The WHO framework outlines these eight interventions:
- Ensure funding for offering services of high quality.
- Focus on most vulnerable and hard-to-reach groups.
- Pay special attention to migrants.
- Ensure vulnerable people are regularly screened for active and latent infections to prevent and manage outbreak.
- Optimize multi-drug-resistant TB prevention and care.
- Ensure that there is no disruption in TB control programs.
- Invest in research and new diagnostic tools.
- Support global TB control.
One of the key issues in the framework is to prevent the breakdown of TB control programs that increases the incidence of outbreaks. Also vulnerable groups like socioeconomically backward classes, people with compromised immune systems like people who are already suffering from some diseases, or heavy drinkers and drug abusers, need to be more effectively screened and given access to all TB outreach programs.
Addressing tuberculosis in the context of cross-border migration can also pose a significant challenge to health service providers. Many undergoing a course of TB treatment may have no option but to relocate for work, even if they have not completed their TB treatment.
"Countries with a low incidence of TB are uniquely positioned to reach historically low levels of TB," added Dr. Mario Raviglione, director of WHO's Global TB Programme. "They can serve as global trailblazers."
Globalization along with benefits brings its set of woes such as spread of diseases due to increased travel and immigration. A person traveling on business from the far-east to the west may carry infectious germs like TB from one end of the world to the other. This may be the reason why even in developed countries, 155,000 people fall prey to the TB bacteria, 10,000 of whom die each year.
The most feasible solution to stop the spread of this disease would be to tackle it at the source — in underdeveloped and developing countries like India, Indonesia, and China, where the incidence of TB is high. And this can be achieved by collaboration and interdependency between the developed and developing nations.
"TB could rebound, including with more drug-resistant forms," said Professor G.B. Migliori from ERS. "But if we get it right, and recommit to fighting the disease, both at home and abroad, TB will eventually no longer be a public health threat."