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The Global Burden of TB

Jun 02, 2018

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    Tuberculosis An Opportunity to Reach Zero Deaths in ourLifetime

    Dr Lucica Ditiu, Executive Secretary, Stop TB Partnership27 th October 2014, Barcelona

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    Which disease is

    responsible for the mostdeaths in the last 200 years

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    theachievem

    ents

    peopletreated for TB since 199556 million

    Reduction in TB mortalitySince 199045%

    Lives savedSince 199522 million

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    403632

    282420141210

    target global10 / 100k / 100k

    TB incidence in the European Region

    theburden

    2013 2018 2023 2028

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    The Missing Cases

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    TB Incidence Rates (per 100,000 popn)

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    What is MDR-TB?

    A form of TB that is resistant to at least twokey anti-TB medicines

    Difficult (terrible side effects) to treat Expensive to treat 150X more than "normal"

    TB (drugs only) Man made Clear sign of under investment and poor TB

    care

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    theburden Why is MDR a public health crisis?

    0

    100

    200

    300

    400

    500

    600

    700

    Est. number of ALL MDRTB cases in the World

    today

    Est. number of NEW MDRTB cases per year

    New cases diagnosed New cases on treatment

    T h o u s a n

    d s

    17,000 patients onwaiting list for treatment

    Less than 25% of estimatednew MDR cases were

    detected in 2012

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    theburden

    27 high MDR-TB burden countries in 2012

    WHO 2013 Global Tuberculosis Report;

    15% in Africa (4)

    55% in Europe (15)

    30% in Asia (8)

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    continuous transmission

    Airborneeveryone issusceptible

    unless we endthe epidemic

    2 billion peopleinfected with TB

    0%200 million

    will develop TB

    1 TB caseinfects up to15 / year

    WHO 2012 Global Tuberculosis Report; CDC 2013; Styblo 1985; Basu 2009

    1 MDR caseinfects up to10 / year

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    thelessonslearned

    lives saveddue to TB & HIV

    integration(2005-2011)

    25 fold increasecases detected & treated

    due to prioritized

    interventions invulnerable populations

    doubleddetection & treatmentthrough engagement

    with TB communities

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    thepotential

    of newtools minutes to diagnoseRif resistant TB with Gene Xpert

    machine90

    new vaccinecandidates inthe pipeline12

    months to treat TBwith new drugs and regimens indevelopment (compared withcurrent 6-24 months)

    4

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    What is the Stop TB Partnership?

    Vision A TB-free world. Zero deaths, disease and suffering due to tuberculosis

    Mission Ensure that every TB patient has access to effective

    diagnosis, treatment and cure Reduce the inequitable social and economic toll of TB Develop and implement new preventive, diagnostic and

    therapeutic tools and strategies to stop TB

    Targets By 2015: the global burden of TB disease (deaths and

    prevalence) will be reduced by 50% relative to 1990 By 2035: 95% reduction in tuberculosis deaths (compared

    with 2015)

    Partners More than 1200 partners Governments, communities and civil society , affected

    people, NGOs, multilaterals, donors, technical agencies,private sector.

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    TBfinancing

    trendsDomestic and international donor funding

    (excluding research and development for new tools)

    Domestic87%

    International13%

    Domestic$5.3 billionFunding gap

    $2 billion

    International$0.8 billion

    WHO 2013 Global Tuberculosis Report;

    Africa48%

    Asia: Other30%

    Rest ofWorld15%

    Asia: Low-income, high

    burden7%

    Funding gaps in 125 countries96% of global burden, 2013

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    TBfinancing

    trendsInternational fundingInternational funding gaps per region per

    year

    Africa$930 million

    Europe $200 million

    Eastern-Mediterranea n

    $160 million

    Western-Pacific

    $150 million

    South-EastAsia

    $150 million

    Americas$30 million

    WHO and Global Fund to Fight AIDS, TB and Malaria March 2013 news release - Urgent need for US$ 1.6 billion a year ininternational financing to prevent spread of disease

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    TBfinancing

    trendsTotal international donor funding per

    year

    TB$0.8

    billion

    Malaria$1.8 billion

    HIV$8.2 billion

    Percentage of total international donorfunding from the Global Fund per year

    TB82%

    Malaria50%

    HIV21%

    WHO, 2013Global Tuberculosis ReportThe Global Fund to Fight AIDS, Tuberculosis and Malaria website

    International donor funding accounts for 50% or more of total fundingin 17 of the 22 High TB Burden Countries (excludes BRICS, which

    make up the other 5)

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    TBfinancing

    trends

    Funding for R&D new tools2012

    Drugs

    38%

    Basic Science21%

    Vaccines14%

    Operationalresearch

    12%

    Infrastructure8%

    Diagnostics7%

    $0.6 billion total

    R&D funding$0.6 billon

    Funding gap$1.4 billion

    Treatment Action Group 2013 Report on Tuberculosis Research Funding Trends, 2005 2012

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    TB is not just a health issue

    But a global economic and security risk

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    economicchallenge micro-

    economic impact of TB onhouseholds

    50%decrease inyearly income

    of schoolchildren quitschool whenparent has TB

    11%of income lostwith TB death15 yrs

    Rajeswari R, Balasubramanian R, Muniyandi M, Geetharamani S, Thresa X, Venkatesan P, 1999. Socio -economic impact oftuberculosis on patients and family in India. Int J Tuberc Lung Dis 3: 869 877.Stop TB Partnership. (2000). Tuberculosis and Sustainable Development.

    Up to

    75%must take out aloan

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    US$ 8billion

    Estimatedeconomicburden of TB peryear in the EUalone

    of TB patientsare in their mostproductive years

    economicchallenge

    75 %

    Source: www.tballiance.org/why/economic-impact.phphttp://www.who.int/tb/careproviders/ppm/workplaces/en/index.html

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    Return on investment for every one dollarspent on the most cost-effective health interventions

    Tuberculosiscase finding& treatmentUS$ 30

    HIVcombination prevention

    US$ 12

    local surgicalcapacityUS$ 10

    heart attacksacute low-cost management

    US$ 25

    expandedimmunization

    US$ 20

    malariaprevention & treatment

    US$ 20

    Economicopport-

    unity

    Report of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda, 2013

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    What weneed

    Attention and support to TBBy world leaders, country governments and YOU In the post-2015 agenda For development of the next Global Plan to stop TB 2016-

    2020

    Increased domestic funding Particularly for high burden and middle income countries

    Increased external funding Increased funding for high-impact programs in addition toGlobal Fund

    Set up an additional channel of fundinge.g. for innovations in care delivery

    Funding for research on new tools

    Integration within countries systems Walk away from vertical interventions Cross cutting areas procurement and supply, health

    information systems, service delivery peripheral level

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    How wecan help

    Connect to relevant in country partners Support on prioritization of areas in need for

    support Engagement of "non traditional" partners

    communities, civil society, private sector Global Fund- NFM related events, activities- TA TB REACH

    Challenge Facility for Civil Society GDFEmail us: [email protected]

    mailto:[email protected]:[email protected]
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