TB-status 2013: Store fremskridt, men alt for mange behandles ikke

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Verden er godt på vej til at opfylde målet om at halvere antallet af tuberkulose-tilfælde i 2015, men bag successen lurer store problemer: Mangel på penge, mandskab og udstyr – det betyder, at alt for mange med nye mere resistente former for TB ikke opdages, endsige behandles.

GENEVA, 23 October 2013 (UN News Service): Treatment has saved the lives of more than 22 million people with tuberculosis (TB), according to a new report by the United Nations health agency that also reveals that the number of deaths from the disease fell to 1,3 million last year.

The Global Tuberculosis Report 2013, published Wednesday by the World Health Organization (WHO), confirms that the world is on track to meet the Millennium Development Goals (MDGs = 2015 Målene) target of reversing TB incidence, along with the target of a 50 per cent reduction in the mortality rate (dødelighed) by 2015 (compared to 1990).

The report also underlines the need for a “quantum leap” (spring fremad i omfanget) in TB care and control which can only be achieved if two major challenges are addressed, WHO stated.

FIRST, there are around three million people – equal to one in three people falling ill with TB – who are currently being ‘missed’ by health systems. WHO estimates that 75 per cent of the three million are in 12 countries.

SECONDLY, the response to test and treat all those affected by multidrug-resistant TB (MDR-TB) is inadequate. Not only are the links in the MDR-TB chain weak, the links are simply not there yet, according to the report.

WHO estimates that 450.000 people fell ill with MDR-TB in 2012 alone. China, India and Russia have the highest burden of MDR-TB followed by 24 other countries.

“Far too many still missing out”

At the heart of both challenges, said WHO, is insufficient resources for TB.

“Quality TB care for millions worldwide has driven down TB deaths,” said Mario Raviglione, WHO Director of the Global TB Programme.

“But far too many people are still missing out on such care and are suffering as a result. They are not diagnosed, or not treated, or information on the quality of care they receive is unknown.”

While the number of people detected worldwide with rapid diagnostic tests increased by more than 40 per cent to 94.000 in 2012, three out of four MDR-TB cases still remain without a diagnosis.

Even more worrying, WHO pointed out, is that around 16.000 MDR-TB cases reported to the agency in 2012 were not put on treatment, with long waiting lists increasingly becoming a problem.

Also, many countries are not achieving high cure rates due to a lack of service capacity and human resource shortages.

“The unmet demand for a full-scale and quality response to multidrug-resistant tuberculosis is a real public health crisis,” Dr. Raviglione stated, noting:

“It is unacceptable that increased access to diagnosis is not being matched by increased access to MDR-TB care”.

“We have patients diagnosed but not enough drug supplies or trained people to treat them. The alert on antimicrobial resistance has been sounded; now is the time to act to halt drug-resistant TB, added he.”

Another challenge, according to the report, relates to the TB and HIV ‘co-epidemic’ (beslægtede epidemier).

While there has been significant progress in the last decade in scaling-up antiretroviral (livsforlængende) treatment for TB patients living with HIV, less than 60 per cent were receiving antiretroviral drugs (medicin) in 2012.

Læs videre og se hele rapporten på
http://www.un.org/apps/news/story.asp?NewsID=46313&Cr=tuberculosis&Cr1=#.UmhoS2Vqr4s

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