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Infectious diseases

Fighting tuberculosis

Tuberculosis detection in Lima, Peru

Tuberculosis is widespread. The World Health Organization (WHO) estimates that a quarter of the world’s population are infected with the pathogen – usually without knowing it. Only a small percentage actually fall ill with TB in the course of their life, although in absolute terms it is still a very large figure, amounting to around 10 million in 2017. Almost two thirds of them live in just eight countries: India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa. With some 1.6 million sufferers dying of tuberculosis in 2017, the disease remains one of the ten leading causes of death worldwide. More than 95 per cent of deaths from TB occur in countries with low to medium income levels.

Many cases undiscovered, increasing drug resistance

Estimates for the proportion of missing and untreated cases of tuberculosis stand at around 40 per cent. This means there are approximately four million people a year becoming infected with a life-threatening disease who may, in turn, infect others. As long as we fail to put in place, especially in the worst-affected countries, comprehensive and systematic screening and treatment services the epidemic will not be eradicated.

In recent years major advances have been made in combatting the disease. New diagnostic methods have been developed and mortality rates have fallen. On the other hand, we find more and more cases in which the TB bacteria have evolved into drug-resistant strains, rendering previously reliable medicines no longer effective. This trend puts at risk the medical advances already achieved and makes tuberculosis a grave global health threat.


Tuberculosis and AIDS

At particular risk of falling ill to tuberculosis are persons with weakened immune systems. In fact, TB was responsible for 40 per cent of deaths of AIDS sufferers in 2016. Efforts to control tuberculosis must therefore be closely coordinated with measures to tackle HIV/AIDS.


Tuberculosis is curable

Mohamed Abdullai who has Tuberculosis, rests in his bed at the MSF Holland hospital in Galcayo south, Somalia.

Tuberculosis can be cured. The standard therapy recommended by the World Health Organization is to take four different drugs over a period of six months. The success rate of this treatment rises significantly when patients are monitored during the therapy by specially trained helpers. Their job is to make sure that patients take their medicine correctly and encourage them to stick to the drug regime despite its frequently unpleasant side-effects. This course of treatment saved around 53 million lives between 2000 and 2016.


German activities

Germany is involved in a number of international initiatives aimed at eradicating the epidemic of tuberculosis. They include: the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund); Gavi, the Vaccines Alliance; and the Global Health Investment Fund (GHIF). The latter focuses on promoting innovative financial solutions tailored to health demands in poor countries.

In the context of development cooperation with partner countries Germany has a strong focus on supporting national tuberculosis eradication programmes in Central Asia (Kazakhstan, Uzbekistan, Kirgizstan, and Tajikistan) and Pakistan. All five countries are characterised by a high incidence of multidrug-resistant TB pathogens.

German activities include

  • Providing quality-assured drugs
  • Developing laboratory and hospital infrastructure for diagnosing and treating all forms of tuberculosis, including multidrug-resistant strains (MDR-TB)
  • Ensuring that prisons are covered by national programmes
  • Promoting measures to inform and educate, especially on prevention
  • Providing social support for patients during their lengthy period of treatment
  • Supporting and strengthening national monitoring and screening capabilities
  • Mobilising the contribution of private health services.

For example, thanks to the support of German laboratories it has been possible to establish effective national reference laboratories in the partner countries. They now have the equipment and expertise needed to diagnose cases of drug-resistance.

Moreover, the Federal Ministry for Economic Cooperation and Development (BMZ) has, since 2016, been helping eight partner countries in Eastern Europe and sub-Saharan Africa to control tuberculosis through its initiative on "Hospital Partnerships – Partners Strengthen Health".


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