Today, the 24th of March 2009, is World TB Day.

On 2 March 1882, Robert Koch discovered the organism that causes tuberculosis. TB is a major public health problem in the WHO African Region. World TB Day 2009 therefore aims to raise awareness of the global TB epidemic and to prompt all of us to intensify our efforts to control the disease. This year’s celebration is centered on the theme "I am stopping TB".

Below we reproduce the full text of the message of Dr Luis Gomes Sambou, regional director of the World Health Organisation for Africa. Some of the countries in the African Region have the highest TB rates in the world. Although the African Region has approximately 10% of the world population, it accounts for 30% of the global TB burden. Nine out of the twenty-two most affected countries world-wide, accounting for 80% of the global TB burden, are in the African Region.

Furthermore, our ability to identify cases well as ensuring successful completion to treatments is below the set targets. This is because a large number of patients in the African Region either discontinuing treatment, or they die, or they are transferred during treatment or they are simply not evaluated. The situation is worrying, considering that TB was declared an emergency by the African Ministers of Health in Maputo in 2005.

TB case notification in the region continues to increase every year, particularly in place where HIV prevalence is high. The latest information available shows that 1.3 million TB case were notified in the African Region in 2007 compared to 1.1 million cases in 2005. Rigorous implementation of the STOP TB strategy, including universal coverage with DOTS, will significantly improve case detection and treatment outcomes. This underscores the need to ensure that the standards of patient care are high in all health facilities. Satisfactory TB treatment outcomes can only be achieved through concerted efforts by governments, health care providers, families and communities who must all be involved in the process leading to the diagnosis of the disease and the successful treatment of the patient.

I therefore call upon all countries to implement the STOP TB strategy in its entirety, including systematic community mobilization which should result in bringing a greater number of suspected TB case to the health facility for screening. Improving access to good quality services will result in increased and prompt diagnosis of patients. We must endeavour to put every single defaults and deaths. That will help break the chain of transmission of TB infection and, eventually, reverse the trend of TB in our Region.

The emergence of Multi-drug resistant TB (MDR-TB) and Extensively – Drug resistant TB (XDR-TB) also poses new challenges. These forms of TB are principally a result of inadequate or poorly administered treatment to identified TB cases. Therefore preventing the emergence of drug resistant TB by providing quality TB care is crucial. In 2007, only 38% TB cases notified in the Region tested for HIV, and 52% of them tested were positive, compared to 22% of TB cases tested by HIV in 2005. That is an improvement, but our aim should be universal testing of all TB patients for HIV. That will help those persons who are infected and affected with both TB and HIV to access HIV/AIDS care and treatment, which will improve their quality of life and help reduce preventable deaths.
 
It goes without saying that the fight to control TB cannot be won by health care providers in the public sector alone. It must be a joint effort of all health providers, including those in the private sector. For their part, individuals, families, and communities should mobilize to contribute to this effort. Each individual, in a family or in a community should help identify and encourage anyone who has a cough of more than three-week duration to go for screening for TB. They should encourage and support people living with AIDS to also go for screening for TB.

Each one of us should contribute to ensuring that those on TB treatment complete the full course which normally takes 6-8months. Obviously, there is still much to do, but I have no doubt that, together we can take giant steps towards a TB-free world.