Health officials warn that next few years critical in TB fight

Public officials from the United States government and the World Health Organization met in Washington, D.C., on Wednesday to discuss the recent findings contained in the WHO's newly released Global Tuberculosis Report 2012.

New research on TB indicates that the next few years will be critical in determining the progress of global eradication efforts. The report maintains that TB imposes an enormous burden on global health, citing the existence of an estimated 8.7 million new cases in 2011, 13 percent of which are co-infected with HIV.

The progress made in the fight against TB has been substantial, the WHO asserts. Access to healthcare has expanded substantially since the 1990s, when WHO launched a global strategy and began efforts to systematically monitor the spread of the contagious and often fatal illness. In the last 17 years, 51 million people have been cured worldwide. Since 1990, TB mortality rates have declined by 41 percent.

Dr. Kenneth Castro of the U.S. Centers for Disease Control and Prevention said that it is important to remain focused on the challenges that have yet to be overcome.

"This is not the time for a premature declaration of victory," Castro said. "Fifty-one million cures, 20 million lives saved is great, but not enough."

Dr. Anthony Fauci, the director of the U.S. National Institute of Allergy and Infectious Diseases, referred to the latest WHO report as a "mix of good news and less good news."

Fauci said that despite significant advances, overall progress against TB is currently "too slow to consider elimination in this century." The director is particularly concerned with the growth of multidrug-resistant TB, saying it threatened overall control efforts. The WHO estimates that only 60,000 MDR-TB cases are currently being treated, despite estimates that nearly 310,000 MDR-TB cases exist.

The outcome of anti-TB efforts, according to the WHO, could hinge on critical funding gaps for care and control, as well as on aid in the development and introduction of new treatments. The report pinpoints the need for $3 billion annually to sustain recent gains and make further progress in at least 35 low-income countries.

"On the one hand we have existing as well as new tools on the horizon which could make a significant difference and even support dreams of elimination (of TB) in some regions," Dr. Mario Raviglione, the director of the WHO's Stop TB Department, said. "On the other hand, we are at the risk of stagnation if additional resources are not urgently mobilized by the governments of affected countries and the international community."

Fauci agreed with Raviglione's assessment that TB is a global problem that requires a global solution.

"Not addressing this is just not an option," Fauci said. "We are a global society - we really have a moral obligation to address this problem. It's something that we just can't walk away from...It is going to be a tough sell, but you are talking about lives that you can absolutely predict will be lost."

Several vaccines are currently in trials, with at least one promising candidate reaching a Phase 2b infant study.

"As the WHO report has highlighted, TB remains a major global threat to public health with escalating drug resistance an increasing concern," Dr. Jacqui Shea, the general manager of the Oxford-Emergent Tuberculosis Consortium, a joint venture between Emergent BioSolutions and the University of Oxford, said. "The TB community agrees that there is an urgent need for new TB vaccines to control this epidemic. OETC and its partners - Aeras, The Wellcome Trust, and the South African Tuberculosis Vaccine Initiative - are eagerly anticipating results from our Phase 2b infant study in early 2013 that would hopefully bring us closer to achieving our unified goal of having new safe and effective TB vaccines."