OVERVIEW: TUBERCULOSIS CONTROL
Tuberculosis (TB) is a disease of poverty, mainly affecting young adults in their most productive years. For the first time in many years, recent World Health Organization data suggest that the absolute number of TB cases has been falling since 2006. Despite this achievement, TB continues to be one of the top causes of death among women ages 15-44, and in 2009 almost 10 million children were orphaned as a result of parental deaths caused by TB. The World Bank is committed to helping developing countries control and reduce the spread of TB.
In 2011, about 1.43 million deaths were attributable to TB, including an estimated 430,000 people with HIV. In 2011, multidrug-resistant TB (MDR-TB) rates were reported to be still increasing. According to a 2010 WHO survey, new TB cases peaked at 28% in some areas of the former Soviet Union, while extensively drug-resistant TB (XDR-TB) cases have been reported in 84 countries, up from 58 in 2010. To meet these challenges, the World Bank has adopted a multi-pronged approach to TB control.
The Bank addresses TB directly but also by supporting tobacco control measures, health systems strengthening, and the improvement of public housing and environment. The Bank supports full-scale implementation of the WHO-recommended “Directly Observed Treatment Strategy” (DOTS). From 2005-2012, the Bank’s cumulative commitments to TB control totaled about US$285 million in 17 projects in 16 countries and three multi-country projects in Africa and Central Asia. The Bank also invests in projects to reduce smoking prevalence. Smoking increases the risk of TB by a factor of more than two-and-a-half times. Health systems strengthening activities that support TB control include the modernization of public health laboratory networks, health personnel training for timely detection and diagnosis, and improved technical capacity at various levels of the health system. This is important for monitoring and evaluation, which is a key building block for disease surveillance, program management, and tailoring policy to the specific needs of the country.
Additionally, the Bank supports improvements in public housing—in particular related to indoor air pollution—which reduce the risk of contracting TB.
The Bank is a permanent member of the Stop TB Partnership's Coordinating Board. Bank staff collaborate with other Stop TB partners at the global and country level.