The Union World Conference on tuberculosis and lung health opens in Cape Town on November 9, with more than 3 000 scientists brainstorming new strategies to attack one of the most successful killers of human beings.
This year the traditionally scientific and sober meeting looks set to develop a harder advocacy edge. Alarmed by the link between TB mortality and HIV infection, health activists are turning their honed advocacy skills to the need for greater resources and political commitment to stop the spread of the disease.
South African scientists are well represented on the packed schedule of the four-day conference, which is focusing on HIV/TB co-infection and drug-resistant disease. TB is the biggest killer of HIV-positive people in South Africa.
Globally TB, which kills more than 1,5-million people a year, is thought to lie latent in almost a third of the world’s population and treatment requires months of antibiotic cocktails. Inadequate rates of diagnosis and succesful treatment have driven the development of multidrug-resistant TB (MDR-TB) and its almost incurable offspring, extensively drug-resistant TB (XDR-TB). At least 41 countries have documented XDR-TB, of which the first widely known outbreak occurred in KwaZulu-Natal.
The 38th Union World Conference on Lung Health is an element of tradition of international collaboration against tuberculosis that goes back to 1867 — before German Robert Koch even identified the bacillus that causes TB and when the disease was known as the White Plague. This is the first time the International Union Against Tuberculosis and Lung Disease, abbreviated to the Union, has held its flagship conference outside Paris.
Last year the World Health Organisation released the Global Plan to Stop TB 2006 to 2015, which sets the target of halving TB infections and deaths from the 1990 levels.
Yet this week the United States-based activist organisation, the Treatment Action Group (TAG), released research showing that money for TB-related research rose by less than 5% between 2005 and 2006 — and that this small increase hid a fall in funding from government organisations. Last year international donors spent $424-million on TB research, which is less than half the amount detailed in the Global Plan.
TAG admitted the limitations of its research since many organisations, including South Africa’s department of health, failed or refused to participate.
The biggest funders of TB research are two US governmental agencies, one of them the National Institute of Health, which, in the 2007 financial year, spent almost as much money on anthrax and smallpox than on TB.
The scorecard
Africa Public Health Rights Alliance’s ‘15% Now†campaign issued a TB scorecard at the start of the conference against TB, lung disease [and HIV] held in Cape Town from November 8 to 12. The TB scorecard showed that:
- Four of the 10 countries with the overall highest TB prevalence are African;
- Eight of the 10 countries with the highest TB prevalence per 100 000 people are African;
- All 10 countries with the highest prevalence per 100 000 of HIV-positive adults are African;
- Poor health financing and falling numbers of health workers are key factors driving TB prevalence;
- SADC is the sub-region most hit by TB prevalence in HIV-positive adults;
- Africa’s pivotal countries — Nigeria, Ethiopia, Kenya, the DRC and South Africa — carry the biggest burden; and
- Kenya is the only country to feature in every category of high-prevalence rankings.
— www.africa15percentcampaign.org