TB cases falling too slowly to hit 2020 targets

更多的人正在接受治疗tuberculosis(TB) than ever before, yet cases are falling too slowly to hit 2020 targets for tackling the disease, according to areport by the World Health Organization (WHO).

WHO 2017年全球结核病报告说，去年，全球约有700万人接受了结核病的治疗。在同一时期，该疾病的死亡人数下降了100,000，达到150万。

这些趋势显示出治疗肺部疾病的进展，肺部疾病是世界上最大的传染性杀手。但是，估计每年有1000万例结核病病例，这仍然意味着他们中几乎三分之一在2018年无法获得护理，或者没有报告案件。

“I have great hope that progress can be made, and there are solutions. But they require commitment and financial investment,”

Philippe Glaziou, senior epidemiologist, WHO Global TB Programme

And things are not moving swiftly enough to meet the goals set out in the WHO’s End TB Strategy for cutting cases in the five years to 2020. TB cases had dropped just 6.3 per cent by 2018, far short of next year’s goal of 20 per cent – and deaths fell only 11 per cent, compared with a 35 per cent target.

Philippe Glaziou, a senior epidemiologist at the WHO’s Global TB Programme, said: “I think there’s more attention given to TB than ever before. We can see some of the results from that, in terms of bridging the gap between case detection and incidence… But reductions are too slow at a global level.”

趋势

India and Indonesia reflect some of the prevailing trends. Those countries accounted for most of the global increase in reporting of TB cases since 2013, but were also two of the three nations with the largest gap between estimated TB incidence and reported cases last year. India alone made up a quarter of the gap, and Indonesia 10 per cent – while Nigeria was the other country in the top three, at 12 per cent.

报告说：“十个国家约占差距的80％。”“特别是在这些国家中，需要加强努力来减少检测到的结核病病例的不足并改善诊断和治疗的机会。”

世卫组织还指出,抗击结核病is “chronically underfunded”: despite its high burden, international资金疟疾只有大约一半，而艾滋病毒仅占14％。格拉齐乌说：“有很大的资金差距。”“更多的资金将大大加速进步。”

He stresses the need for simpler, shorter drug regimes and efforts to address the risk factors for the disease.艾滋病病毒,undernutrition，吸烟和糖尿病都可能导致更高的风险。

“在减轻负担方面，结核病控制的成功不仅是查找和治疗案件；这也是要解决风险因素。”他补充说。

Positive side

尽管如此，七个高负责人的国家仍有望实现2020年的结核病发生率和死亡的目标 - 肯尼亚，莱索托，缅甸，俄罗斯，俄罗斯，南非，坦桑尼亚和津巴布韦。

Glaziou says the factors for decreases in these countries vary widely, but some have seen reductions through programmes to reduce HIV. The report says that Myanmar has seen declines in TB cases of about 7 per cent per year over the last 10 years, aided by expansion of service coverage, better links with the private sector and increased financing from the政府和国际资源。

最近的例子还显示了近年来跟踪结核病疾病负担的来源如何“大大改善”。该报告引用了缅甸以及越南进行的重复调查，该调查目前正在达到与2015年相比，到2020年，TB死亡人数为35％的里程碑。

Yet Southeast Asia saw the most cases of TB worldwide in 2018, at 44 per cent of the total, compared with 24 per cent for Africa.

尼日利亚伊巴丹大学药学学院的研究员尤苏夫·阿德比西（Yusuff Adebisi）说：“结核病仍然是发展中国家的主要公共卫生威胁。”他补充说，很难评估西非等国家的结核病的确切患病率和负担，因为“ [全球]南方的数据报告系统仍然很差”。

他呼吁改善对研发的投资，并提高政府解决问题的承诺。

In its Sustainable Development Goals, the UN has set a target of 2030 to end the TB epidemic.

Glaziou believes it is possible progress could accelerate, pointing to positive recent signs emerging for finding a vaccine. “If we have a breakthrough, things could change dramatically,” he said.

“I have great hope that progress can be made, and there are solutions. But they require commitment and financial investment.”