Scaling up interventions to achieve global tuberculosis control: progress and new developments

Raviglione, M; Marais, B; Floyd, K; Lonnroth, K; Getahun, H; Migliori, GB; Harries, AD; Nunn, P; Lienhardt, C; Graham, S; Chakaya, J; Weyer, K; Cole, S; Kaufmann, SHE; Zumla, A; (2012) Scaling up interventions to achieve global tuberculosis control: progress and new developments. Lancet, 379 (9829). pp. 1902-1913. ISSN 0140-6736 DOI:

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Tuberculosis is still one of the most important causes of death worldwide. The 2010 Lancet tuberculosis series provided a comprehensive overview of global control efforts and challenges. In this update we review recent progress. With improved control efforts, the world and most regions are on track to achieve the Millennium Development Goal of decreasing tuberculosis incidence by 2015, and the Stop TB Partnership target of halving 1990 mortality rates by 2015; the exception is Africa. Despite these advances, full scale-up of tuberculosis and HIV collaborative activities remains challenging and emerging drug-resistant tuberculosis is a major threat. Recognition of the effect that non-communicable diseases-such as smoking-related lung disease, diet-related diabetes mellitus, and alcohol and drug misuse-have on individual vulnerability, as well as the contribution of poor living conditions to community vulnerability, shows the need for multidisciplinary approaches. Several new diagnostic tests are being introduced in endemic countries and for the first time in 40 years a coordinated portfolio of promising new tuberculosis drugs exists. However, none of these advances off er easy solutions. Achievement of international tuberculosis control targets and maintenance of these gains needs optimum national health policies and services, with ongoing investment into new approaches and strategies. Despite growing funding in recent years, a serious shortfall persists. International and national financial uncertainty places gains at serious risk. Perseverance and renewed commitment are needed to achieve global control of tuberculosis, and ultimately, its elimination.

Item Type: Article
Keywords: drug-resistant tuberculosis, xpert mtb/rif test, isoniazid preventive, therapy, hiv-infected adults, mycobacterium-tuberculosis, antiretroviral, therapy, pulmonary tuberculosis, intrathoracic tuberculosis, noncommunicable diseases, antituberculosis drugs, Antitubercular Agents, therapeutic use, Biological Markers, analysis, Biomedical Research, trends, Communicable Disease Control, methods, Community Health Services, organization & administration, Financing, Organized, Forecasting, HIV Infections, complications, mortality, Humans, Incidence, Prevalence, Social Support, Tuberculosis, complications, mortality, prevention & control, Tuberculosis Vaccines, Tuberculosis, Multidrug-Resistant, mortality, prevention & control, World Health
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 22608339
Web of Science ID: 304194200032


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