Three of the world's six regions are expected to achieve targets for tuberculosis (TB) control, according to a World Health Organization (WHO) report published on 22 March 2006.

The Americas, South-East Asia and the Western Pacific regions should reach targets set by the World Health Assembly to detect 70 per cent of TB cases and successfully treat 85 per cent of these cases by the end of 2005, according to the Global Tuberculosis Control 2006. The report confirms that 26 countries had already met the targets a year ahead of time, two of them being the high-TB burden countries of the Philippines and Viet Nam. It also indicates that five other high-burden countries-Cambodia, China, India, Indonesia and Myanmar-should have reached the targets within the 2005 time frame, though final confirmation will come at the end of 2006.

WHO Director-General Dr. Lee Jong-wook said: "There is clear evidence that investment in TB control works. Even in low-income countries with enormous financial constraints, programmes are operating effectively and producing results. This same commitment needs to be replicated in African countries and other areas where funding and priority for TB control remains fragile."

The latest estimates in the report suggest that 1.7 million people died from TB in 2004 and there were also 8.9 million new cases, with its number per capita rising at 1 per cent per year globally as a consequence of the TB crisis in Africa-a crisis attributed partly to the complications of HIV infection and poor health systems. Eastern Europe, with its high prevalence of multi-drug-resistant tuberculosis (MDR-TB), also continues to have an adverse impact on the global treatment success rates.

Despite the cost-effectiveness of TB control, there is concern that African leaders are still failing to seriously invest in it. Response to the 2005 TB emergency declaration in Africa has been, for the most part, far too sluggish. The report highlights the need for a much more rapid and vigorous response to the African TB emergency, including more ambitious plans that are backed up by more funding from Governments and donors. Kenya is one country that is responding to the emergency declaration's call for "urgent and extraordinary actions" to address TB and TB/HIV. Its Minister of Health, Charity Kaluki Ngilu, said: "Kenya is determined to make a difference. We are taking a strong and decisive lead in TB control through our own national TB emergency plan. This is a strategic plan that lays out the actions and resources required to reduce the misery caused by unnecessary TB deaths."

Other new initiatives, with the shared aim of improving access to TB treatments for all, were also launched in Geneva prior to World TB Day which is 24 March. A set of International Standards for Tuberculosis Care, describing the level of care all health practitioners should follow, together with a new Patients' Charter for Tuberculosis Care, outlining for the first time the rights and responsibilities of people with TB, were also released on 22 March. The two documents are important inclusions in a new six-point Stop TB Strategy developed by WHO and are highlighted in the Stop TB Partnership's Global Plan to Stop TB, 2006-2015, which was launched in January 2006.

The six components of the new Stop TB Strategy are: pursue high-quality DOTS expansion and enhancement; address TB/HIV, MDR-TB and other challenges; contribute to strengthening the health system; engage all care providers; empower the communities and people with TB; and enable and promote research. The increased momentum around TB control has been stimulated by commitments to the Global Plan to Stop TB, underpinned by the Strategy. However, for the Plan to succeed in saving 14 million extra lives, a ten-year funding gap of $31 billion must be bridged. This is equivalent to just $2 a year from every person in the industrialized world.

Several countries are on track to eliminate the infectious eye disease, known as blinding trachoma, the World Health Organization (WHO) announced on 10 April 2006. This progress results from efforts to achieve the global goal set by the World Health Assembly in 1998 to eliminate this disabling disease by 2020.

The estimated number of people affected by trachoma has fallen from 360 million people in 1985 to approximately 80 million today-the result of a concerted effort by the WHO Alliance for the Global Elimination of Blinding Trachoma by 2020 (GET 2020), combined with socioeconomic development in endemic countries. The disease affects the poorest and most remote rural areas of 56 countries in Africa, Asia, Central and South America, Australia and the Middle East.

At a GET 2020 meeting in Geneva in April, the Islamic Republic of Iran, Mexico, Morocco and Oman reported successfully implementing national strategies of interventions for eliminating trachoma, based on the WHO-recommended SAFE strategy, which emphasizes comprehensive public health action. SAFE stands for lid surgery (S), antibiotics to treat the infection (A), facial cleanliness (F) and environmental changes (E). If implemented comprehensively, the strategy could prevent virtually all cases of blindness. Dr. Lee Jong-wook, WHO Director-General, said that "if countries continue at this rate, the global goal to eliminate blinding trachoma as a public health problem by 2020 can be achieved".

WHO is developing the specific epidemiological assessment criteria to determine whether countries have fully eliminated trachoma, to be finalized by the end of 2006, at which time WHO will be able to evaluate the effectiveness of national strategies and provide country-by-country certification that the disease has been eliminated.

Trachoma originates from an eye infection that is spread from person to person, frequently from child to child and from child to mother, especially in environmental conditions caused by water shortages, flies and crowded households. Through the discharge from an infected person's eyes, trachoma is passed on by hands, on clothing or by flies. Infections often begin during infancy or childhood and become chronic. If left untreated, it will eventually cause the eyelid to turn inward, and the eyelashes to rub on the eyeball, resulting in intense pain and scarring of the eye, which ultimately leads to irreversible blindness. Women are two to three times more often affected than men, probably due to their close contact with infected children.

Launched in 1997, GET 2020 is a partnership to support country implementation of the SAFE strategy. Alliance members include WHO, national governments, non-governmental organizations, research institutions, foundations and the pharmaceutical industry. Membership is open to all sectors willing to work with Governments to implement the strategy. Pfizer Inc. and its foundation have been key partners in the fight against trachoma. It has donated 37 million doses of azithromycin-a long-acting antibiotic used as one component of the SAFE strategy-and has committed to provide 100 million additional doses by 2008.

An independent Commission on Intellectual Property Rights, Innovation and Public Health formally presented its report to the WHO Director-General, Dr. Lee Jong-wook, recommending key actions needed to ensure that poor people in developing countries have access to existing and new products to diagnose, treat and prevent diseases that affect them most. The report contains more than 50 recommendations that serve as a road map for tackling the issues in different country settings. "We are grateful to the Commissioners for undertaking this difficult task. With this report, the Commission has built a solid foundation from which countries can move forward. I encourage all countries to give serious consideration to their role in addressing these critical issues", Dr. Lee said.

Over half of the people in the poorest parts of Africa and Asia lack regular access to existing essential medicines because they cannot afford them or their country's health system is too weak. Apart from access to existing medicines, some health products, specifically for diseases that disproportionately affect developing countries, are simply not developed at all due to the lack of a sustainable market. The relationship between intellectual property rights, innovation and public health has been at the heart of debate.

The report, titled Public Health, Innovation and Intellectual Property Rights, is the result of a two-year analysis of how Governments, industry, scientists, international law and financing mechanisms can work best to overcome the challenges. "There is now global momentum to address these issues and we have a unique opportunity to build on this. There is more awareness, more money potentially available, more utilization of scientific capacity in developing countries and new institutions, such as public-private partnerships", said Ruth Dreifuss, Chair of the Commission.

The report is clear that we must build on this to ensure that poor people in developing countries have sustainable access to medicines, vaccines and diagnostics they need now, she added. It "maps out the ways this can be done".

The report will be examined by the World Health Assembly during its annual meeting in May 2006, which will ultimately decide how its findings will be applied.