12th October 2014 - the Lancet Global Burden of Disease Report and tuberculosis
You may have seen the Gates Foundation-funded Global Burdens of Disease report...
There was some truly earth shaking stuff tucked away in it
which hasn't been reported in the media but which we believe deserves much better publicity. We wonder if you agree..
1. The report estimated 1.3 million HIV deaths in 2013 (they
believe that UNITAID have overestimated the numbers), and 1.4 million TB deaths
in this same period (which is a little more than WHO's estimates). This is of huge
significance since it means that HIV has passed back the title of ‘most
lethal infectious disease’ to its previous title-holder, tuberculosis. This
should surely be waking folk up more to the ongoing threat from TB, and should certainly
be being highlighted (if these estimates are correct, and even these may be
2. Furthermore, if you care to wade through to 'fig 13' of the report (on page 27) you'll find something even more alarming. This graph shows that (contrary to all WHO estimates and reports) both prevalence and incidence rates for TB are actually still rising globally (though they do see mortality rates as slightly declining). As you may know, the Millennium Development Goal (MDG) for TB (which has long been recognised as being unambitious and which was superseded nearly ten years ago by other tougher goals) was simply to 'halt and reverse' it. According to this Lancet report even this meagre ‘halting and reducing’ hasn't yet been achieved 21 years into a global health emergency. If this is true, it represents an appalling and massive failure in public health which should be being talked about in the highest of places. In four simple words, it is a scandal.
3. Lastly, the Lancet piece unfortunately reveals itself to be guilty of
the usual lack of clarity on MDR-TB, stating that it has “not separately
examined the incidence, prevalence, and mortality related to multi-drug
resistant tuberculosis (MDR-TB)”.
Given the scale of the current threat and the resource being awarded to this study, we ask “WHY NOT?”
DR-TB is hardly new, and yet there remains an abysmal
response to monitoring it (let alone addressing the disease) even from an august (and enormous) team of experts
like the ones who authored this report.
Ebola may be currently taking the
headlines, but TB is still taking the lives - and DR-TB remains the biggest
threat to the world's poor.