TB is still a Health Threat in the Caribbean

Port-of-Spain, Trinidad and Tobago, March 23, 2015:  The Caribbean Public Health Agency (CARPHA) joins the Region in observing World Tuberculosis (TB) day.  The Day is used to build public awareness that TB remains a major global health problem, responsible for illness among 9 million new people each year, and deaths of 1.5 million. Worldwide, TB ranks as the second leading cause of death from an infectious disease, after the human immunodeficiency virus (HIV).  This year’s theme Find, Treat, Cure TB focuses on TB diagnosis and case detection of those still not reached.

CARPHA Executive Director Dr. C. James Hospedales stated that “TB remains a public health priority for the Caribbean region with more than 30,000 new cases occurring every year.”  Persistent cough, fatigue, fever, night sweats, and weight loss are common signs and symptoms of TB, and persons experiencing these symptoms should consult their doctor.

Progress toward TB control in the Caribbean has been slow, despite recognition that emergence and/or increasing trends for the disease pose a threat to public health.  The Caribbean, as a region, still has to increase its efforts in order to achieve the United Nations Millennium Development Goal (MDG) 2015 target to reduce by 50% the burden of TB (disease prevalence and deaths) relative to the 1990 levels.  Several Caribbean countries still have high TB incidence rates, and HIV/AIDS, shortage of laboratory capacity, limited treatment success and programme funding gaps, are among the factors favouring TB continuing to pose a significant health threat in the Region.

The Caribbean Public Health Agency (CARPHA) serves as the regional reference and referral laboratory for the diagnosis of TB and drug resistant TB in the Caribbean.  The Agency provides assistance to TB programmes in its Member States, investigates TB outbreaks, and contributes to the regional TB surveillance through yearly reporting to the World Health Organization (WHO).  CARPHA is equipped with a molecular diagnostic system (GeneXpert®) for the fast detection of TB and for TB resistant to Rifampicin (one of the antibiotics used to treat TB).

In order to make further progress towards the new MDG goals, Dr. Hospedales said “TB control must be mainstreamed into the health agenda as with HIV, and include broader strategic planning approaches and financial frameworks aimed at poverty reduction.  He further stated that “it is essential that Caribbean countries ensure high quality TB services through implementing the components of the Stop TB Strategy, and that target prevention and control activities fit their respective epidemiological situation.”  

Efforts should be strengthened to ensure good quality TB programmes that enable prompt identification and adequate management of people with TB, as well as necessary infection control measures.  This includes strengthening of HIV counseling and testing among people with TB, making Antiretroviral Therapy (ART) available for all people with TB living with HIV, and better data to assess the performance of TB/HIV collaborative activities including prevention of TB among people living with HIV in the population.

The end of 2015 marks a transition from the MDGs to a post-2015 development framework. WHO has developed a post-2015 global TB strategy (the End TB Strategy) that was approved by all Member States at the May 2014 World Health Assembly.  The overall goal of the strategy is to end the global TB epidemic, with corresponding 2035 targets of a 95% reduction in TB deaths and a 90% reduction in TB incidence (both compared with 2015), and 2050 target of TB elimination as a public health problem (defined as <1 case per 1 million population per year).

Dr. Hospedales stressed that it is the Region’s “collective responsibility” and that “efforts to combat TB must be accelerated if the post-2015 targets are to be met.  Political commitment, as well as communication, cooperation and collaboration with healthcare workers at all levels of the health sector and the population at large, are essential for the achievement of TB programme goals.”


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