The total number of new tuberculosis (TB) cases remained stable in 2007, and the percentage of the world's population becoming ill with TB has continued the slow decline that was first observed in 2004, according to a new report released by WHO today.
However, the 2009 global TB control report also reveals that one out of four TB deaths is HIV-related, twice as many as previously recognized. In 2007, there were an estimated 1.37 million new cases of tuberculosis among HIV-infected people and 456 000 deaths. This figure reflects an improvement in the quality of the country data, which are now more representative and available from more countries than in previous years.
"These findings point to an urgent need to find, prevent and treat tuberculosis in people living with HIV and to test for HIV in all patients with TB in order to provide prevention, treatment and care. Countries can only do that through stronger collaborative programmes and stronger health systems that address both diseases," said Dr Margaret Chan, Director-General of WHO.
Sharp increase in HIV testing
The report reveals a sharp increase in HIV testing among people being treated for TB, especially in Africa. In 2004, just 4% of TB patients in the region were tested for HIV; in 2007 that number rose to 37%, with several countries testing more than 75% of TB patients for their HIV status.
Because of increased testing for HIV among TB patients, more people are getting appropriate treatment though the numbers still remain a small fraction of those in need. In 2007, 200 000 HIV-positive TB patients were enrolled on co-trimoxazole treatment to prevent opportunistic infections and 100 000 were on antiretroviral therapy.
"We have to stop people living with HIV from dying of tuberculosis," said Mr Michel Sidibe, Executive Director of UNAIDS. "Universal access to HIV prevention, treatment, care and support must include TB prevention, diagnosis and treatment. When HIV and TB services are combined, they save lives."
Greatest challenges
TB/HIV co-infection and drug-resistant forms of tuberculosis present the greatest challenges, the report says. In 2007 an estimated 500 000 people had multidrug-resistant TB (MDR-TB), but less than 1% of them were receiving treatments that was known to be based on WHO's recommended standards.