DATA BRIEFS: (Continued)
Despite progress, TB treatment reaches too few
About one third of those ill with AIDS actually die from tuberculosis — their weakened immune systems making them easy prey
for this disease. Driven in large part by the AIDS epidemic, TB is on the rise, now killing an estimated 2 million people each
year.
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But while life-prolonging drugs for AIDS remain a distant reality in the developing world, a highly effective and inexpensive
treatment is available for TB. A strategy called DOTS, which stands for Directly Observed Treatment, Short Course,
recommended by WHO, can cure up to 95% of TB cases and stem the spread of drug-resistant TB, while at the same time
improving the quality of life for those who already have AIDS. As its name conveys, the treatment involves, in particular, the
observation of patients swallowing appropriate dosages of anti-TB medicines for the full course of treatment, critical for the
prevention of the multidrug resistant strains of TB which have emerged in recent years.
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| Children await registration for immunizations at one of the many UNICEF-assisted health clinics in China |
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Yet, only 16% of TB patients are receiving the recommended treatment. In 12 of the 22 countries where 80% of the world's
TB cases occur, the DOTS strategy reaches fewer than half of those affected. Only five countries are making good progress:
Cambodia, Kenya, Peru, Tanzania and Viet Nam have implemented DOTS programmes countrywide, with high success rates
in detection and treatment.
In Peru, which once had one quarter of South America's TB cases, DOTS is successful in treating 85% of cases.
Brazil, however, which currently has the highest number of cases in South America, lacks a national DOTS strategy. Nigeria,
the Russian Federation and Uganda are reaching less than 10% of cases. India, with an estimated 1.8 million TB cases — 23%
of the world's total — has made some progress in recent years, reaching four times as many people in 1998 as in 1997. And
China, with more than 1 million cases, has built an effective DOTS-based programme, but it only reaches half the country.
TB treatment scorecard for most-affected countries*
| Good progress: Where more than half of TB cases are being treated in the DOTS** programme, with a greater than 70% success rate. |
Some progress: Where between 10% and 50% of TB cases are being treated in the DOTS programme, with a greater than 70% success rate |
Slow progress: Where the DOTS programme is either not used or is used to treat less than 10% of TB cases. |
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Cambodia
Kenya
Peru
Tanzania
Viet Nam |
Bangladesh
China
Ethiopia
India
Indonesia
Myanmar
Philippines
South Africa
Thailand
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Afghanistan***
Brazil
Congo, Dem. Rep.***
Nigeria
Pakistan***
Russian Fed.
Uganda
Zimbabwe
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* Where 80% of the world's TB cases occur.
** Directly Observed Treatment, Short Course.
*** Implementing DOTS but data not available.
Source: WHO.
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