Development Ratings

Target Tuberculosis was set up in 2003 in response to the WHO declaration of TB as a Global Emergency. It builds on the original work of the Ryder-Cheshire Foundation in India. It now has projects in Zambia, India, Pakistan, Bangladesh, East Timor, and Malawi, and new projects are being launched in Tanzania and Uganda.

The 2015 MDG of halting and beginning to reverse the incidence of TB is on target in all regions except Europe. (Incidence is the number of new cases a year relative to all cases.) The WHO’s Stop TB Partnership target of halving prevalence and deaths by 2015 compared to 1990 is not on target. Africa and Europe lag behind. (Prevalence is the total number of cases in the population at a given time.) Achieving the target could save 14m lives. DOTS is the WHO’s Directly Observed Therapy Short-course protocol for treating TB. It requires political commitment, access to diagnostic facilities, uninterrupted access to TB drugs, and proper case management and treatment recording. The TB bacterium is spread on airborne water droplets. Currently, diagnosis involves sputum testing (an insensitive method involving testing several samples over a period). Prevention via the BCG vaccine is effective for only 80% of people for 15 years. The first new, effective vaccine is due by 2015. Current prevention involves earlier treatment, awareness and improving living conditions.

In Zambia, TB incidence has increased 5 fold over 20 years due to the HIV epidemic. It is estimated that 60% of the adult population of Bangladesh is infected with latent TB (WHO). Latent TB has the potential to develop into active TB during times of lowered immunity, such as under malnutrition or crisis conditions. India has the highest incidence of infectious TB in the world. Some 1,000 people a day die of TB in India. In Pakistan, over 100,000 people develop TB every year. In East Timor, health services were undermined by over 25 years of conflict. There is only one dedicated TB doctor in the country. In Malawi, 12,000 people die from TB each year.

Other major research, advocacy and direct action organisations fighting TB include TB Alert, the WHO, the World Lung Foundation, the Global Fund to Fight AIDS, TB and Malaria, the International Union against TB and Lung Disease, health ministries and others. The aims of all the organisations are compatible and complementary.