22 Jul 2013, BioSpectrum Bureau , BioSpectrum
As the world celebrated Nelson Mandela's 95th birthday on July 18, the iconic figure is in critical condition suffering from recurring and severe lung infection, which is speculated to be stemmed from the strain of tuberculosis that he contracted during his 27 years in Pollsmoor Prison in Cape Town, South Africa in 1988.
Tuberculosis is one of the deadliest diseases in the world affecting nine million people worldwide and caused 1.4 million deaths in 2011, according to Centers for Disease Control and Prevention (CDC). Tuberculosis is also the leading killer in patients affected with HIV.
Some facts on globe's effort in controlling Tuberculosis:
• In 2011, there were an estimated 8.7 million new cases of TB (13 percentage co-infected with HIV) and 1.4 million people died from TB, including almost one million deaths among HIV-negative individuals and 430 000 among people who were HIV-positive.
• Geographically, the burden of TB is highest in Asia and Africa. India and China together account for almost 40 percentage of the world's TB cases.
• About 60 percent of cases are in the South-East Asia and Western Pacific regions. The African Region has 24 percent of the world's cases, and the highest rates of cases and deaths per capita.
• New cases of TB have been falling for several years and fell at a rate of 2.2 percent between 2010 and 2011. The TB mortality rate has decreased 41 percentage since 1990 and the world is on track to achieve the global target of a 50 percentage reduction by 2015
• The roll-out of Xpert MTB/RIF, a rapid molecular test that can diagnose TB and rifampicin resistance within 100 minutes, has been impressive. Between its endorsement by WHO in December 2010 and the end of June 2012, 1.1 million tests had been purchased by 67 low- and middle-income countries; South Africa (37 percentage of purchased tests) is the leading adopter.
• The development of new drugs and new vaccines is also progressing. New or re-purposed TB drugs and novel TB regimens to treat drug-sensitive or drug resistant TB are advancing in clinical trials and regulatory review.
• Eleven vaccines to prevent TB are moving through development stages.
• There are critical funding gaps for TB care and control. Between 2013 and 2015 up to US$ 8 billion per year is needed in low- and middle-income countries, with a funding gap of up to US$3 billion per year.
• Research to develop a point-of-care diagnostic test for TB and Multi-drug-resistant tuberculosis (MDR-TB) continues, and other diagnostic tests are in the pipeline.
• Today, standard treatment for TB patients lasts six months and the regimen for most patients with drug resistant TB takes 20 months.
(Source: Global Tuberculosis Report: 2012 by the World Health Organization)
Many companies and institutions such as Bill & Melinda Gates Foundation, Novartis, Sandoz, TB Alliance and Tibotec are working actively in the field of TB.
Lilly MDR-TB Partnership is a public-private initiative led by Eli Lilly and Company that encompasses global health and relief organizations, academic institutions and private companies. The partnership is working to transfer technology and expertise on how to manufacture two of Lilly's antibiotics (cycloserine and capreomycin) used to treat MDR-TB. These medicines are supplied through the WHO's Global Drug Facility.
United States Agency for International Development (USAID) is an independent US government agency that receives overall foreign policy guidance from the Secretary of State. The USAID Regional Development Mission for Asia (RDMA) manages regional programs that benefits all of East Asia and much of South Asia and the Pacific. RDMA supports tuberculosis (TB) activities in nine high-burden countries (HBCs) such as Bangladesh, Burma, Cambodia, China, India, Indonesia, the Philippines, Thailand, and Vietnam.
Global Fund is a global public-private partnership initiative dedicated to attracting and disbursing additional resources to prevent and treat AIDS, tuberculosis and malaria. The Global Fund was established in 2002. It has raised funds mainly from the governments of the G8 countries and the Bill & Melinda Gates Foundation, as well as other government agencies, foundations, and private companies. It has approved proposals totaling $19.2 billion in 144 countries, saving an estimated 4.9 million lives.