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THE FIGHT TO STOP TB WHAT ARE WE FIGHTING? TUBERCULOSIS: THE WORLD’S NO. 1 KILLER AMONG CURABLE, INFECTIOUS DISEASES But there is hope PEOPLE WHO HAVE BEEN CURED CAN SHOW US HOW TO WIN THE FIGHT TO STOP TB AGENDA THE FIGHT TO STOP TB • About TB • The Strategy • The Targets • The Benefits of Progress • The Obstacles to Progress • TB Patients • How Can I help? DOTS CURED ME. IT WILL CURE YOU TOO! 1. ABOUT TB THE FACTS TB: Global Incidence ABOUT TB THE FACTS: • More people die from TB than from any other curable infectious disease in the world. 1 Every second someone in the world is infected with TB. 4 Every minute someone dies from TB. 6 Every day 25 000 people develop active TB and 5000 die of the disease. 12 TB costs the world an estimated US$12 billion. 20 One person with infectious TB infects between 10 and 15 people on average in one year. DOTS CURED ME. IT WILL CURE YOU TOO! ABOUT TB TB: Global Incidence Rate per 100 000 0-9 10 - 24 25 - 49 50 - 99 100 - 300 300 or more No Estimate Source: WHO DOTS CURED ME. IT WILL CURE YOU TOO! ABOUT TB TB: Global Incidence • TB infects both rich and poor people. • But 80% of the global TB burden is carried by just 22 countries, already severely impacted by malnutrition, poor sanitation and poverty. Africa Nigeria Ethiopia South Africa DR Congo Kenya UR Tanzania Uganda Mozambique Zimbabwe Source: WHO Asia India China Indonesia Bangladesh Philippines Pakistan Viet Nam Thailand Myanmar Afghanistan Cambodia DOTS CURED ME. IT WILL CURE YOU TOO! Europe / Americas Russian Federation Brazil 2. THE STRATEGY We have a weapon to fight TB: DOTS DOTS cures more than 80% of cases DOTS is free The Strategy: DOTS DOTS is the best weapon we have in the fight to STOP TB • DOTS (Directly Observed Treatment Strategy) is the internationally recommended strategy to control TB. • DOTS is a proven, standardized method of fighting TB. • DOTS has cured 10 million people since 1994. • DOTS has been described by the World Bank as “one of the • most cost-effective of all health interventions.” DOTS CURED ME. IT WILL CURE YOU TOO! The Strategy: DOTS DOTS is now implemented in 155 countries. Implementation in < 10% of pop Implementation in 10 to 90% of pop Implementation in > 90% of pop DOTS CURED ME. IT WILL CURE YOU TOO! Not implementing DOTS Low incidence non-DOTS country No report The Strategy: DOTS DOTS is effective: More than 4 out of 5 patients who complete their treatment are cured. DOTS SUCCESS RATES in % 85 80 100 90 80 70 60 50 40 30 20 10 0 Target for 2005 Target for 2005 Achieved Today Achieved Today DOTS CURED ME. IT WILL CURE YOU TOO! 3. THE TARGETS To fight TB we have two clear and measurable targets: 1. Detection 2. Cure Where are we today? 3. The Targets We have clear and measurable targets to fight TB: Detection and cure through DOTS. DETECTION AND CURE TARGETS FOR 2005 in % 100 90 80 70 60 50 40 30 20 10 0 85 70 DETECTION DETECTION TREATMENT SUCCESS TREATMENT SUCCESS DOTS CURED ME. IT WILL CURE YOU TOO! 3. The Targets Where are we TODAY? Detecting new cases is the main PROBLEM and therefore we need to double our efforts to achieve our 2005 target. ACHIEVED vs. TARGET 100 80 70 60 85 80 32 40 20 0 Det ect ion Target Det ent ion A chieved Treat ment success Target DOTS CURED ME. IT WILL CURE YOU TOO! Treat ment Success A chieved 4. THE BENEFITS OF PROGRESS What are they? THE BENEFITS OF PROGRESS By achieving our objectives of 70% detection and 85% cure rates, we will Halve TB prevalence and deaths by 2010 = 5.000.000 LIVES SAVED! DOTS CURED ME. IT WILL CURE YOU TOO! 5. OBSTACLES TO PROGRESS A major obstacle in the fight to STOP TB is the rate of case detection. WE MUST ACCELERATE TB DETECTION RATES! OBSTACLES TO PROGRESS Cases notified under DOTS (%) 80 WHO target 70% 70 60 accelerated progress: target met in 2005 50 40 30 20 DOTS begins 1991 current rate of progress: target met in 2013 10 0 1990 1995 2000 2005 2010 2015 Year Source: Global Tuberculosis Control. WHO Report 2002. WHO/CDS/TB/2002.295 DOTS CURED ME. IT WILL CURE YOU TOO! World Health Organization 6. TB PATIENTS We have thousands of allies in the fight to STOP TB: PEOPLE WHO HAVE BEEN CURED. They can show us how to STOP TB. 6. TB Patients CURED TB PATIENTS ARE THE BEST TB ADVOCATES The most effective messages come from cured TB patients. We must find them! We must give them a voice! They are living proof that TB CAN BE CURED! DOTS CURED ME. IT WILL CURE YOU TOO! 6. TB Patients CURED TB PATIENTS ARE THE BEST TB ADVOCATES It is important that people with TB are visible in their communities. Stigma, especially among women, limits our efforts to STOP TB. Therefore... Involve TB patients in advocacy activities. It could be the difference between life and death. DOTS CURED ME. IT WILL CURE YOU TOO! 6. TB Patients CURED TB PATIENTS ARE THE BEST TB ADVOCATES • Give cured TB patients the opportunity to tell their stories with the support of TB partners, national programs and NGO’s. This will encourage other potential TB sufferers to come forward and be diagnosed and cured. • Create opportunities for patients to speak at the local, national and global levels. DOTS CURED ME. IT WILL CURE YOU TOO! 6. TB Patients CURED TB PATIENTS ARE THE BEST TB ADVOCATES PERU is PROOF: Peru was on the list of countries with the highest TB burden. After a street demonstration of TB patients, the government responded with commitment, resources and action. The result? TB cases/100,000 Peru is no longer on that list. 220 200 180 160 140 120 100 1980 DOTS 1990 case finding PTB falling at 6%/yr 1985 1990 DOTS CURED ME. IT WILL CURE YOU TOO! 1995 2000 6. TB Patients CURED TB PATIENTS ARE THE BEST TB ADVOCATES BANGLADESH is PROOF: In Bangladesh, the Damien Foundation detected 11,641 cases of TB in 2000. 25% of them were identified by former TB patients! DOTS CURED ME. IT WILL CURE YOU TOO! 6. TB Patients CURED TB PATIENTS ARE THE BEST TB ADVOCATES We must identify high profile figures to be advocates for TB. Their role: 1. To prompt action among people at risk of TB. 2. To help overcome the social stigma of TB. DOTS CURED ME. IT WILL CURE YOU TOO! 7. HOW CAN I HELP? I want to advocate for TB, but how? How can I help? Do you know people who have been cured of TB? • Encourage them to come forward. Have you been cured of TB? • Become an ambassador for TB. • Become a treatment partner. Do you want to help? • Contribute to the formation of TB advocacy groups. • Join your local Partnership to STOP TB. DOTS CURED ME. IT WILL CURE YOU TOO! SUMMARY What have we learnt? SUMMARY TB is a devastating disease: It is the World´s No. 1 killer among curable, infectious diseases. However, we have a proven method to STOP TB: DOTS. To fight TB with DOTS, we have two measurable targets: • 70% detection. 85% cure. • Case detection is our main challenge. For accelerating case detection we have thousands of allies: People who have been CURED. If you know people who have been cured of TB or you have been cured yourself, you can help by: • Coming forward or encouraging others to come forward. • Becoming an ambassador for TB. • Becoming a treatment partner. REMEMBER... If we achieve our target rates of detection and cure, 2010!!! DOTS CURED ME. IT WILL CURE YOU TOO! 5.000.000 lives will be saved by Thank YOU! www.stoptb.org DOTS CURED ME. IT WILL CURE YOU TOO!