Global Tuberculosis Control 2010 - Florida Department of Health

ogress made towards achieving the impact targets
set for 2015 – to halt and reverse the incidence of TB
by 2015 (MDG Target 6.c), and to halve prevalence and
mortality rates compared with a baseline of 1990 (the
targets set by the Stop TB Partnership) – is illustrated
at the global level in and at the regional level
in , and . 1 Progress in
achieving reductions in incidence and mortality is shown
for each of the 22 HBCs in and .
Globally, rates of incidence, prevalence and mortality
are all declining (). Incidence rates are falling
slowly, at around 1% per year, following a peak at just
over 140 cases per 100 000 population in 2004. If current
trends are sustained, then MDG Target 6.c will be
achieved. Mortality rates have fallen by one third since
1990, and prevalence rates are also in decline. Projections
suggest that the target of halving mortality by
2015 compared with 1990 could be achieved at global
level. The target of halving the prevalence rate appears
out of reach. It should be noted, however, that there is
more uncertainty about trends in prevalence, compared
with trends in mortality (see also ).
Regionally, incidence rates are declining in five of
WHO’s six regions (). The exception is the
South-East Asia Region (where the incidence rate is stable),
largely explained by apparent stability in the TB
incidence rate in India. Further evaluation of trends
in the disease burden in India is needed, and has been
planned for early 2011. Among the five regions where
incidence rates are falling, the rate of decline varies from
less than 1% per year in the Eastern Mediterranean and
European regions to around 2% per year in the African
Region (since 2004) and 4% per year in the Region of
the Americas. As also illustrated in , notifications
are closest to estimated incidence in the Region of
the Americas and the European Region, indicating that
the highest rates of case detection are achieved in these
regions (see also ). As incidence falls slowly,
notifications are increasing in the African Region and
(particularly since 2000) in the Eastern Mediterranean
and South-East Asia regions, indicating improving rates
of case detection. In the Western Pacific Region, notifications
increased sharply between 2002 and 2006, but
have since stabilized; here, patterns are strongly influenced
by China, which accounts for almost 70% of incident
cases in this region ().
The latest assessment for the 22 HBCs suggests that
incidence rates are falling or stable in all countries
except South Africa (). Trends in incidence
rates are assumed to be stable in Afghanistan, Bangladesh,
India, Indonesia, Myanmar and Pakistan, in the
absence of convincing evidence to the contrary (
). The stability in TB incidence rates in India (which
accounts for 61% of cases in this region) as well as Bangladesh,
Indonesia and Myanmar explains the flat trend
in estimated incidence in the South-East Asia Region.
Incidence and notifications Mortality Prevalence
140
35
300
Rate per 100 000 population
120
100
80
60
40
20
30
25
20
15
10
5
250
200
150
100
50
0
0
0
1990 1995 2000 2005
1990 1995 2000 2005 2010 2015 1990 1995 2000 2005 2010 2015
1
See in of this report for definitions of the global
targets for TB control.