World TB Day is held each year on March 24th and aims to build public awareness for tuberculosis. A disease which despite being curable, remains a destructive epidemic in much of the world.

On this day, we commemorate Dr Robert Koch’s announcement in 1882 of his discovery of the TB bacillus, the cause of tuberculosis. His groundbreaking research opened the way toward diagnosing and curing this disease.

World TB Day is an opportunity for people everywhere to join this fight by helping to educate others about TB and by urging governments to take action.

10 million lives could be saved from dying in the next 5 years.

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This curable disease known to humanity for thousands of years is now the top infectious disease killer on the planet, with 4,400 victims every single day. TB and HIV/AIDS are “partners in crime”, often affecting the same persons, and reducing their hope for life, especially when they have resistant forms of TB. The rate of decline of TB incidence is so slow that if the current situation continues, it will take up to 2182 to reach the World Health Organization’s End TB targets.

Epidemiological data

TB worldwide

Tuberculosis is still a global health problem, especially in undeveloped countries and developing countries.

Today, a third of the world’s population is infected with the tubercle bacillus, ie has latent tuberculosis, which means that people have been infected with TB bacteria, but they are not (yet) suffering from the disease and they can not transmit the disease.

One of the world’s major health challenges are 9 million new TB cases and 1.5 million deaths worldwide. 3,3, million people are either not diagnosed or not treated

Every minute 3 people die of TB and 4400 people die a day.

HIV / AIDS in the world contribute to significantly increased the number of patients with tuberculosis. HIV infection is the most known factor which allows progression to tuberculosis infection disease.

In 2014 for the first time in the decade, tuberculosis kills more people than any other infectious disease in the world. That same year in the world were: 9.6 million cases of tuberculosis, 1.5 million deaths due to tuberculosis, 1.2 million people with HIV who develop TB and 0.4 million deaths. 489,000 people developed multidrug resistant tuberculosis, with 190,000 deaths.

Tuberculosis in Macedonia

In 2013 in the Republic of Macedonia is registered prevalence of active TB from 20.8 per 100 000 inhabitants or 428 cases. In 2014 in the Republic of Macedonia is registered prevalence of active TB from 18.8 per 100 000 inhabitants, or 389 cases. In 2015, 15.5 per 100 000 inhabitants, or 321 cases.

In 2014 in the Republic of Macedonia is registered the incidence of active tuberculosis from 13.8 per 100 000 inhabitants or 285 newly infected cases, while in 2013 the incidence was 15.7 per 100 000 inhabitants or 323 newly infected with TB., and in 2015, 284 new cases. Macedonia is among the countries with a low incidence in the European region

Groups of people at increased risk for infection with TB

Reduced defense system (immunity), makes it a higher risk of contracting TB.

An estimated 74,000 children worldwide die from TB every year, mostly who are poor, live in environments where there is limited access to health care and have no knowledge about the disease.

The risk of contracting TB is high among drug users (due to decreased immunity of drug use, living conditions and reduced access to health care).

The risk groups include also prisoners and patients in psychiatric hospitals

Reduced immunity increases the risk of contracting TB among people with diabetes.

Worldwide, around 1 billion people are migrants. Among them, there is also a high risk of infection with TB (fatigue, improper diet, low immunity, staying crowded in rooms).

TB is a major cause of death among people living with HIV (worldwide, there is one death in three people infected with HIV due to TB).

Global Strategy for tuberculosis

In September 2015, the General Assembly of the United Nations approved the so-called. Sustainable Development Goals. The third goal is: To complete TB epidemic by 2030.

Assembly of WHO in May 2014 adopted a resolution that fully supports the Global Strategy for tuberculosis. Strategy of the WHO ,, The End TB Strategy” sets a goal in 2030 to end the epidemic with tuberculosis.

The strategy focuses on early detection, treatment and prevention, so all suffering from tuberculosis to have equal access to services, but also to be involved in their care.

By 2035 strategy sets out the following objectives:

  • 95% reduction by 2035 in number of TB deaths compared with 2015.
  • 90% reduction by 2035 in TB incidence rate compared with 2015.
  • Zero TB-affected families facing catastrophic costs due to TB by 2035.

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“Everyone with TB should have access to the innovative tools and services they need for rapid diagnosis, treatment and care. This is a matter of social justice, fundamental to our goal of universal health coverage. Given the prevalence of drug-resistant tuberculosis, ensuring high quality and complete care will also benefit global health security. I call for intensified global solidarity and action to ensure the success of this transformative End TB Strategy.”
Dr. Margaret Chan, Director General, World Health Organization

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Principles

  • Government stewardship and accountability, with monitoring and evaluation.
  • Strong coalition with civil society organizations and communities.
  • Protection and promotion of human rights, ethics and equity.
  • Adaptation of the strategy and targets at country level, with global collaboration.

The objectives of the strategy

  • Integrated, patient-centred care and prevention.
  • Early diagnosis of tuberculosis including universal drug-susceptibility testing, and systematic screening of contacts and high-risk groups.
  • Treatment of all people with tuberculosis including drug-resistant tuberculosis, and patient support.
  • Collaborative tuberculosis/HIV activities, and management of co-morbidities.
  • Preventive treatment of persons at high risk, and vaccination against tuberculosis.
  • Bold policies and supportive systems.
  • Political commitment with adequate resources for tuberculosis care and prevention.
  • Engagement of communities, civil society organizations, and public and private care providers.
  • Universal health coverage policy, and regulatory frameworks for case notification, vital registration, quality and rational use of medicines, and infection control.
  • Social protection, poverty alleviation and actions on other determinants of tuberculosis.
  • Intensified research and innivation.
  • Discovery, development and rapid uptake of new tools, interventions and strategies.
  • Research to optimize implementation and impact, and promote innovations.

Active discovery of new cases of tuberculosis in risk groups is also very important. This activity may include the community.

Regular medications are provided for curing and preventing the development of resistant forms of TB. Therefore, it is applied the so-called- directly observed treatment, which means the direct control of the treatment and monitoring of patients with tuberculosis, and health education of patients and their families.