The World Health Organisation warned that progress in tackling tuberculosis was far too slow, as it doubled its estimate of the ravages the disease is causing among HIV/Aids patients.
Some 9.27 million people contracted TB in 2007, an increase of about 30 000 over the previous year mainly in line with population growth, according to the WHO's annual report on tuberculosis control. They included some 1.4 million people with HIV/Aids, compared to an estimated 600 000 in 2006 reported last year.
More than one death in four – 456 000 of the 1.75 million tuberculosis deaths recorded in 2007 - is now thought to involve an HIV/Aids patient. "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," said WHO Director General Margaret Chan in a statement.
Developing countries hardest hit
However, the report reiterated that there were severe shortcomings in tackling tuberculosis and coordinated care for both diseases largely due to feeble heath care in the developing countries that are the hardest hit.
Just one in seven HIV patients receive vital preventive treatment for TB, said WHO HIV/Aids director Kevin De Cock.
Overall, more than one third of tuberculosis cases are not diagnosed, leaving many out of reach of treatment and, crucially, increasing the risk of spreading the contagious disease, according to the UN health agency.
A thousand years to beat TB
While the overall rate of TB infection fell in three years to 139 cases per 100 000 people, the improvement was too slow, said Mario Raviglione, the agency's anti-tuberculosis chief. "We are talking about less than 1% per year, which will get us to potentially eliminate TB in a very distant future: we are talking centuries if not millenia in a way," he told journalists.
The growth in the estimated impact on HIV/Aids patients was largely down to better data and understanding. "The revision... is illustrative of the fact that people living with
HIV have a risk of developing tuberculosis that's 20 times greater than HIV-negative people," said De Cock. Despite progress in testing TB patients for HIV in Africa, the
combination of poor diagnosis, rising drug resistance and the evidence of the impact on highly-vulnerable HIV/Aids patients has heightened alarm among health experts.
Resistance the 'Achilles heel'
Detection of the highly-contagious disease has stagnated after a sharp improvement nine years ago, while the impact drug-resistant strains of the TB bacteria has grown to infect an estimated 500 000 people. Just one percent of them receive treatment and 150 000 of them die, according to the WHO, which regards resistance as the "achilles heel" of the anti-TB drive.
"The scale-up of interventions to deal with multidrug-resistant TB is not at the pace we would like to see and is far from the targets that have been established," Raviglione said. Furthermore, 10% of them were almost incurable extensive-resistant strains (XDR-TB) that are now found in 55 countries. – (Sapa, March 2009)
HIV and Tuberculosis: The scourge of Africa