deaths (with a range of 53,000 to 170,000) (WHO, 2010b,c).1 Failure to treat these cases adequately increases the risk of the disease spreading to others.

Salmaan Keshavjee, Harvard Medical School, presented an overview of the global profile of TB and drug-resistant TB using data provided by Matteo Zignol, STOP TB Partnership, WHO. Keshavjee also described the global challenges to effective treatment and control of drug-resistant TB, with a focus on the slow pace of treatment scale-up and the consequences of inaction. In addition, Gail Cassell, Harvard Medical School and Infectious Disease Research Institute, presented data from another high-burden country—China, which will host the fourth and last workshop in the Forum’s series.

OVERVIEW OF THE GLOBAL BURDEN OF TB AND MDR TB2

According to official WHO data reported by countries in 2009, the estimated number of new cases of TB worldwide was 9.4 million, with a range of 8.9 to 9.9 million. The estimated number of deaths from TB, excluding those among HIV-positive people, was 1.3 million, with a range of 1.1 to 1.5 million (WHO, 2010b).3

About 1 in 8 cases of TB are associated with HIV—an estimated total of 1.1 million people (ranging from 1.0 to 1.2 million). Among these individuals, 380,000 deaths occur each year (ranging from 320,000 to 450,000). Overall, approximately 4,600 people die each day on average from TB, both with and without HIV coinfection.

According to WHO, the incidence of TB peaked in 2004 and has declined slightly since then. The prevalence of TB has been declining and by 2015 will be approaching, although it will not achieve, the Millennium Development Goal of half the 1990 level. With respect to mortality, the Millennium Development Goal of half the 1990 level will be achieved if the current trend continues (WHO, 2010b).

A substantial gap exists between global notifications of TB each year and estimated incidence, indicating that many people are not being reached by current approaches. The treatment success rate for regular TB has been improving—to 87 percent according to 2009 data (WHO, 2011a). However,

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1 See footnote 4 in Chapter 1 and the updated WHO (2011a) report on TB control for more information on global estimates of MDR TB.

2 This section is based on slides prepared for the workshop by Matteo Zignol, STOP TB Partnership, WHO, and presented by Salmaan Keshavjee, Assistant Professor, Harvard Medical School.

3 An updated WHO (2011a) report, released after the workshop, estimates that in 2010, there were 8.8 million new cases of TB, 1.1 million deaths from TB in HIV-negative individuals, and an additional 0.35 million deaths from HIV-associated TB.



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