What is tuberculosis?
TB is an airborne infectious disease, caused by the bacterium Mycobacterium tuberculosis. It typically affects the lungs and is spread when a person who is sick with TB expels the bacteria in the air in tiny drops of fluid, for example by coughing. TB is treatable and curable with a course of antibiotics.
There are about ten million new cases of TB every year. TB disproportionately impacts people in low and middle income countries, where the majority of TB deaths occur. In fact, TB is the world’s leading infectious disease killer, with approximately 1.3 million deaths among HIV negative people and an additional 300,000 cases among people with HIV infection. Drug resistant TB continues to be a public health crisis, with approximately 558,000 cases of drug resistant TB per year. Treatment outcomes are poor for this group, with only 55% successfully competing treatment.
The response to the global TB epidemic is guided by the End TB Strategy. The focus is on reducing TB incidence, reducing TB deaths and reducing the costs of care for patients. In Australia, the national response to TB is guided by the National TB Strategic Plan: 2016-2020, soon to be released by the Commonwealth Department of Health.
Why is drug resistant TB an urgent issue to address in our region?
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. Our current capacity to address drug resistant TB is limited. The increase in drug resistant TB is linked to broader health system deficiencies and limited tools to manage it. The major challenges are:
- Knowledge gaps:
- Epidemiology: country level data and surveillance.
- Out-dated tools for diagnosis, treatment and prevention.
- Implementation gaps:
- Out-dated models of care.
- Ambition gaps:
- Limited political commitment from Governments and severe under-funding.
- Inadequate investment in research and development.
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 epidemic 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 drug resistant TB is highly cost-effective. Drug resistant-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 drug resistant 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 development, and to support our neighbours in strengthening health services and systems.