London TB plan aims to fight dramatic rise in infections

The U.K. National Health Service’s London Health Programs recently released a draft of its plan to combat tuberculosis in the British capital, which now has the highest TB rate of any capital city in Western Europe.

The London TB plan was created in response to a 50 percent increase in the number of TB cases in the city since 1999. The plan aims to reduce the TB rate by 50 percent over the next 10 years through a range of proposals intended to improve early detection of the disease, improve the effectiveness of treatment and reduce the risk of transmission.

To improve the early detection of TB, the London TB plan calls for a program to increase awareness across the city. Both the general population and health and social workers are to be targeted in the campaign, which will focus on the recognition of early signs of the disease and who is most likely to contract it. A screening protocol will also be developed for use by clinicians to standardize the practice of identifying patients.

According to the LHP, TB treatment in London has been hampered by a lack of centralized direction and a failure to work with local authorities and community groups to coordinate care. The new model of care proposes to establish a central TB commissioning body for the city that can consistently implement case management and risk assessment tools. The London TB Commissioning Board would be jointly accountable to the NHS and the London Health Improvement Board, which is chaired by the Mayor of London.

In order to reduce the risk of TB transmission, the plan intends to improve data collection and surveillance on existing cases in order to monitor and plan responses to the development of TB clusters and outbreaks. London is to be considered a single geographical entity for vaccination purposes. Because the average TB rate across London is more than 40 per 100,000, it will be recommended that all children be vaccinated within six weeks of birth.

The LHP is seeking comments on the TB plan from doctors, patients, community organizations, and public health and social service members. The London TB plan will then be revised and submitted for approval from NHS commissioners in the fall of 2011.