Advances made, but the battle against TB is not over yet

One-third of the world's population is infected with dormant TB. Approximately 9.2 million people develop the active form of the disease each year. This highly contagious active form spreads through the air from one person to another through coughing and sneezing. About 1.7 million people die annually of TB.

The American people are making major investments to prevent and control TB in countries around the world where the burden of the disease is highest. Through our active engagement in the STOP TB Partnership, we are a key partner to intense global efforts to achieve the Partnership's Global Plan targets to halve TB prevalence and deaths by 2015 relative to 1990 levels. Achieving this goal could save 14 million lives, not to mention the economic benefits for nations.

There is good news to share. According to The 2009 Global Tuberculosis Control Report, released today by the WHO, TB prevalence and death rates are falling globally, while detection of new cases of TB and access to high-quality anti-TB treatments are on the rise.

Three of six regions in the world (the Americas, the eastern Mediterranean and Southeast Asia) are on track to achieve the Global Plan's 2015 targets, and the Western Pacific Region is making strong strides toward the goal.

In addition to its support through the Global Fund, the United States government actively supports TB programmes in the six countries in the Greater Mekong sub-region (GMS): Burma, Cambodia, China, Laos, Thailand and Vietnam. While the Asia region is making tremendous strides, the HIV/Aids epidemic and the presence of multi drug-resistant (MDR) TB is hampering the progress of the national TB programmes in the GMS. These six countries account for 26 per cent of the world's new MDR-TB cases.

In Thailand, over 90,000 people develop TB each year, including 15 per cent who also have HIV. The United States government is working with the Thai Ministry of Public Health to introduce improved ways to control TB, introduce new and better diagnostic tests, and conduct practical research on the best ways to find and treat TB in people who have HIV. Support is also focused on strengthening Thailand's role in serving as a regional TB reference laboratory. Improved TB testing in Thailand has resulted in 83 people being identified as having MDR-TB, enabling them to receive life-saving medications and preventing further spread of the disease.

However, much work remains to be done. Neither Africa nor Europe is on track to meet the targets. Because HIV fuels the TB epidemic, the number of HIV-positive TB cases and deaths are twice what was previously thought. Multi-drug resistant (MDR) TB threatens to undermine years of progress in TB control, because the treatment requires different and more costly drugs. New approaches to diagnose TB, coupled with improved health delivery systems and stronger community awareness, are critical to earlier detection and treatment.

The United States remains fully committed to working with all of our partners to renew the charge against TB. The American people have donated US$3.3 billion to the Global Fund (GF) since 2002. Almost $1.71 billion has been approved by the GF for phase 1 and 2 TB grants in 91 countries. Global Fund investments have provided 3.9 million people with treatment for tuberculosis.

The United States is the largest single-country bilateral donor for TB, and since 1998 it has provided more than $777 million to global TB control programmes. The United States is a leading donor to the Global TB Drug Facility to expand access to, and availability of, high-quality anti-TB drugs, providing nearly $15 million in 2008. More than 450,000 patients will benefit from this life-saving assistance from the American people.

On World Tuberculosis Day, the Embassy of the United States renews its pledge to work with the Royal Thai government to successfully implement the Global Plan to Stop TB. The lives of millions of people across the globe depend on true international cooperation.

Olivier Carduner is mission director for the Regional Development Mission for Asia, United States International Aid and Development.

Michael Malison is director of the Centres for Disease Control (CDC), Southeast Asia Regional Office.

James Boles is commander of the Armed Forces Research Institute of Medical Sciences.