Joint solutions to joint epidemics: IDF supports World TB Day

World TB Day 2010 - 24 March

The world is facing the convergence of several epidemics. Infectious diseases, such as TB and HIV, and chronic non-communicable diseases (NCDs), including diabetes, cardiovascular disease and cancers, represent a burgeoning health emergency – especially in poor regions. According to the World Health Organization (WHO), TB was responsible for the death of 1.77 million people in 2007 (including 456,000 people with HIV) – about 4800 deaths a day.

While TB is a worldwide epidemic, the vast majority of TB deaths occur in the developing world, where diabetes is also emerging as a major health problem. Among the 15 countries with the highest estimated TB incidence rates, 13 are in Africa, while half of all new cases are in Asian countries. According to IDF, in the near future, four out of five people with diabetes worldwide will be living in a developing country.

Both TB and HIV share important overlap with diabetes and cardiovascular disease. Diabetes, like tobacco smoking, is strongly linked to negative TB outcomes. People with diabetes have up to a four-fold greater risk for developing active TB than people without diabetes. TB affects mostly young adults in their most productive years; it is a leading killer among people living with HIV, who have weakened immune systems.

The evidence is mounting of the potentially devastating effects of this constellation of epidemics on social and economic development, as well as public health. A coordinated international approach is urgently required. Managing chronic infectious and chronic non-communicable diseases jointly has long been accepted in high-income countries. This is now extremely important in countries undergoing disease transition in the developing world. Opportunities exist to exploit the logistical routes used to detect and treat TB and HIV in order to support the prevention and management of chronic NCDs. Common approaches must be found to combat these diseases.

WHO’s Stop TB Strategy aims to reduce by 2015 the prevalence of and deaths due to TB by 50% relative to 1990, and reverse the trend in incidence. The strategy emphasizes the need for proper health systems and the importance of effective primary healthcare.