Two decades ago, the World Health Organization declared tuberculosis a global health emergency and soon after launched a global TB strategy that was eventually adopted by nearly every country. More than 50 million people have since been successfully treated for this highly contagious disease, and 20 million lives saved.
The world has already achieved the Millennium Development target of halting and reversing the TB epidemic by 2015. We are on track to meet the global target of a 50 per cent reduction in deaths from 1990 levels, although Africa and Europe still lag behind.
New diagnostics, new drugs and the promise of new vaccines have the potential to further accelerate progress against TB, which still kills 1.4 million people a year – more than any infectious disease other than AIDS. But two obstacles stand in the way.
The first is the emergence of TB strains that fail to respond to first-line drugs. Worldwide, an estimated 630,000 people are infected with multi-drug-resistant TB – inflicting new burdens on patients, families and health systems and threatening to reverse hard-won gains.
The second is the need for funding. Drug resistance is a major addition to the health budget: it costs at least 10 times more to treat multi-drug-resistant TB than drug-sensitive TB. Low- and middle-income countries are already footing two-thirds of the bill for TB care and control. They rely on the international community to provide the remaining third.
On this World Tuberculosis Day, which comes just over 1,000 days before the Millennium Development Goal deadline, it will be critical to ensure these countries can afford the cost of preventing deaths from TB and arresting its spread. This is central to ending TB in our lifetime.