What is Tuberculosis?
TB is an airborne infectious disease, which is preventable and curable, and caused by the bacteria Mycobacterium tuberculosis. It typically affects the lungs and is spread in the air when a person who is sick with TB expels the bacterium in tiny drops of fluid, for example by coughing.
TB disproportionately impacts developing countries, where 94 per cent of TB cases and 98 per cent of TB deaths occur. TB causes more deaths than any other infectious disease in our region. To reach the World Health Organization’s target of ending the TB epidemic by 2050, accelerated and innovative approaches are needed to bridge the current knowledge, implementation and ambition gaps that hinder progress.
TB prevention and care responses focus on finding and effectively treating infectious cases as early as possible, to prevent further spread of the disease. Multidrug-resistant TB (MDR-TB, which is resistant to the most effective first line drugs) and extensively-resistant TB (XDR-TB, which is resistant to the both first line and second-line drugs) herald the prospect of virtually untreatable tuberculosis.
Why address DRT-TB as an urgent issue?
A recent commissioned report has projected that in 2050, drug-resistant microbes will kill more people than cancer. Drug-resistant TB was listed among the top three of these deadly drug-resistant diseases. More than half of drug-resistant TB cases are found in Australia’s adjoining neighbours in the Asia Pacific region.
The drug-resistant tuberculosis crisis provides urgency and focus for coordinated action to improve regional health and development
Cases are increasing and spreading. The number of people estimated to fall ill each year with drug-resistant TB continues to rise: from 290,000 in 2010 to 480,000 people in 2013. However, only 20 per cent of these people received appropriate treatment.
Our current capacity to address DR-TB is limited. The increase in DR-TB is linked to broader health system deficiencies and limited tools to manage it. The major challenges are:
- Knowledge gaps:
- Basic science: TB pathogenesis and transmission.
- Epidemiology: country level data and surveillance.
- Out-dated tools for diagnosis, treatment and prevention.
- Implementation gaps:
- Out-dated models of care, a resource intensive model to bring to scale.
- Ambition gaps:
- Limited political commitment from Governments and severe under funding.
- Inadequate investment in research and development.
From crisis to opportunity. Investment and coordinated action from both governments and business enterprises within this region is required urgently to avert this regional threat.
The benefits for Australia of addressing the regional TB threat include:
- It contributes to maintaining Australia’s health security. TB has no respect for our borders. The most effective way to protect Australia is to contribute to TB care and prevention programs in those high disease burden countries with which we have trade, migration, tourism and other travel links.
- Investing in TB and DR-TB is highly cost-effective. DR-TB regimens in development are expected to lower the cost of treatment for some patients by 90 per cent, reduce treatment duration by 75 per cent, and deliver an all-oral therapy, simplifying treatment delivery and making treatment widely scalable.
What are the risks of inaction?
TB will continue to spread if no new action is taken.
Besides the human cost, TB in general, and DR-TB in particular, places an extraordinary economic burden on communities and traps people in poverty. It is estimated TB will rob the world’s poorest countries of an estimated $1 to $3 trillion over the next 10 years.
There is a compelling case for Australia to continue to invest in innovative TB research, and to support our neighbours in strengthening health services and systems.