Fewer people are dying of tuberculosis in South-East Asia

New Delhi, 21 March 2013:  Significantly fewer people are dying of tuberculosis today in South-East Asia compared with 1990, according to the World Health Organization. The death rate due to the disease has decreased by more than 40% in the past 13 years. This achievement is attributed to greater public awareness of TB, an increased number of cases being detected, and more people having access to adequate treatment because of the sustained efforts by Member States, assisted by WHO.  On World TB Day 2013, WHO calls on Member States to “Stop TB in South-East Asia – zero death to zero infection.”

Emphasizing that tuberculosis elimination is a social and public health responsibility, Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia Region, said, “To successfully eliminate TB, we must pay attention to the underlying causes of the spread of the disease, such as poverty, the environment, and nutrition.”  He added, “Expanding services to billions of people, of diverse languages and cultures, faced with rapid urbanization and large population displacements in many countries is a major task. TB detection and treatment facilities must be made accessible and affordable to the hard-to-reach and unreached populations at the primary health centres.”

As access to TB care has expanded substantially, the number of people with TB, or the TB prevalence rate, has also declined by a fourth in the Region compared with 1990. All 11 Member countries of the Region have adopted the WHO Stop TB Strategy. More than 88% known TB patients have been successfully treated. Five countries have had a bigger treatment success rate: Bangladesh (92%), Bhutan (90%), Democratic People’s Republic of Korea (90%), Indonesia (90%), and Nepal (90%).

Good performance by countries in implementing DOTS (directly observed treatment, short-course), the cornerstone for ensuring  TB is successfully treated, has led to relatively low levels of multidrug resistant TB in newly detected cases.

Advances in diagnostics are also contributing to success in TB control.  Six countries in this Region – Bangladesh, India, Indonesia, Myanmar, Nepal and Thailand – have introduced Xpert MTB/RIIF, a system that detects the disease, including TB that is resistant to the antibiotic rifampicin, rapidly, within 100 minutes. Rapid detection of TB enables health providers to ensure patients get treated quickly and appropriately, and prevents its spread.

However, absolute numbers are still high. There were an estimated 5 million TB patients in 2011 in the Region, with 3.5 million new cases. Half a million people died of TB that year. There were also an estimated 90 000 cases of multidrug-resistant (MDR) TB in 2011.  This is nearly a third of the estimated number of people with MDR-TB in the world. This is mainly due to the large and growing population in this Region.

Substantial challenges remain. An estimated one third of TB cases continues to remain unreported. Such cases are of concern as they unknowingly help spread the disease in the community and pose a serious risk of drug-resistant TB. This makes successful treatment difficult, and leads to high TB mortality.  There is a need to increase technical and managerial capacity within national programmes, provide additional funding for TB programmes, extend community-based care, and develop new tools and improve laboratory capacity to better diagnose and more effectively treat patients and stop multidrug resistant TB.

TB elimination cannot be achieved by the health sector alone. It requires coordinated efforts by other sectors, such as environment, infection control, water and sanitation. With adequate resources and dedicated efforts, it is possible to “Stop TB in South-East Asia – zero death to zero infection” in this generation.