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[e-drug] Global TB Drug Facility launched

E-DRUG: Global TB Drug Facility launched 
[3 press releases because of World TB day; WB]

Global TB Drug Facility launched in Washington DC

"We have to bring in more funding to take quality drugs to the people that
need them most. I am urging you on behalf of the young and the old, the
impoverished and the imprisoned, to join us in efforts to Stop TB. Your
involvement will move us closer to our aim of a world where no one will be
denied access to DOTS." Dr Gro Harlem Brundtland, Director-General, WHO

With just 4 days to go to World TB Day 2001, the Stop TB Partnership
Secretariat is pleased to announce the launch of the Global TB Drug Facility
(GDF) in Washington DC today. The full text of a press releases jointly
issued by the World Health Organization (WHO) and Stop TB is reproduced
below. The press release is also available in French on the Internet on the
WHO homepage at http://www.who.int/. A summary of the Global TB Drug
Facility and of the WHO Report on Global TB Control 2001 follows. The full
text of the Report is available at

Press Release WHO/13 20 March 2001
EMBARGOED UNTIL 00h01 GMT 21 March 2001


The World Health Organization (WHO) and the global partnership to Stop TB
today announced a new initiative to increase access to tuberculosis (TB)
drugs for ten million patients over the next five years. The Global TB Drug
Facility, which is housed by WHO and managed by the Stop TB partnership,
aims to significantly increase access to high quality TB drugs. WHO called
for a commitment of at least US$50 million per year for the next five years
to the Global TB Drug Facility.

The Global TB Drug Facility will be launched in Washington DC on 21 March
2001, and will finance procurement of quality TB drugs for countries with a
high burden of TB. The aim of the Global TB Drug Facility is to provide TB
drugs for ten million patients over the next five years and 45 million
patients over a 10-year period. 

With an initial contribution from the Canadian International Development
Agency, the Global TB Drug Facility recently approved grants to several
countries in Africa, Asia and Eastern Europe to treat nearly 200,000
patients. A second round of applications will be processed by July 2001,
enabling the Global TB Drug Facility to provide drugs for nearly half a
million TB patients in its first year of operations. 

Although developing countries, which together account for over 90% of the
global TB burden, are the main target for the Global TB Drug Facility,
industrialized countries will indirectly benefit from the support it
provides. As the global population becomes more mobile, there is abundant
evidence that national borders are no obstacle to the spread of TB.
Outbreaks of infection acquired during air travel are a growing hazard, and
most worryingly, several of these have resulted from Multi Drug Resistant TB
- a form of TB that is expensive and difficult to cure. Hot spots of MDR TB
have been found in many countries, particularly in countries of the former
Soviet Union. Controlling TB in any single country means controlling TB
globally. Investing in the Global TB Drug Facility  is not just a
humanitarian responsibility for developed nations - it makes good public
health sense.

"Access to treatment and care is basic to human rights,"  said Dr Gro Harlem
Brundtland, Director-General of the World Health Organisation. "When access
is neglected or denied, health and human rights suffer. We all know that
poor people suffer most of infectious diseases, and TB provides one of the
clearest examples. It is shameful that many TB patients are still dying of
the disease, and inexcusable  that less than a quarter of them have access
to effective TB treatment", she added. 

The theme for World TB Day, which is commemorated each year on 24 March, the
anniversary of the discovery of the germ that causes TB, is "DOTS: TB cure
for all", highlighting the importance of ensuring access to treatment for
all people with TB; whether rich or poor, young or old, male or female,
irrespective of race, ethnicity, social status, or the many other means by
which people in need are deprived of treatment that should be theirs. It
draws attention to those TB patients who have special needs, such as people
with HIV and those with drug resistant TB.

TB is the world's leading curable infectious killer. Every day 20,000 people
develop active TB, and 5,000 die from their disease. Without treatment,
about 70% of people with TB will die, and untreated, a single person with
infectious TB can infect between 10-15 people a year. The global TB epidemic
increased 6% between 1997 and 1999, largely due to a 20% increase in African
countries affected by the HIV/AIDS epidemic. If these trends continue, some
10.2 million new cases are expected each year by 2005.

The continued growth of this epidemic is totally unnecessary and completely
avoidable. DOTS - the WHO approved strategy for TB control, cures patients,
saves lives, prevents the spread of drug resistance, and reduces
transmission of the disease. The social and economic benefits are equally
profound. Yet progress in expanding DOTS remains totally inadequate. In a
report published this week, WHO announced that only 23% of people with
infectious TB were treated in DOTS programmes. Unless there is a rapid
acceleration of DOTS expansion, global targets to detect 70% of people with
infectious TB, and cure 85% of those detected will not be met until 2013 by
the earliest. 

A significant barrier to rapid DOTS expansion is drug shortages. A 6-8 month
course of treatment for TB costs as little as US$ 10. Still, shortages of TB
drugs are frequent and serious, often caused by financial constraints,
inefficient drug procurement systems, and poor management. The drugs used to
treat TB have been available for over three decades, yet millions of
patients still do not have access to effective treatment. 

"Future generations will no doubt ask us why we continued to allow two
million people to die every year from a disease that can be cured with drugs
that cost only $10-15. They will rightly question our commitment, our
priorities, our sense of justice, and our understanding of human rights",
said Dr JW Lee, Director of the WHO department to Stop TB. 

A year ago on World TB Day, Ministers of Health, Finance and Planning from
20 of the highest TB burden countries in the world met in Amsterdam for a
conference on TB and Sustainable Development. They set ambitious objectives
to mobilize political commitment and to reach the global targets by 2005, to
prevent further spread of TB and multi-drug resistant TB, and called on the
international community for assistance. The Amsterdam Declaration to Stop TB
called for "new international approaches towards ensuring universal access
to, and distribution of tuberculosis drugs." The Global TB Drug Facility has
been established by WHO and the global partnership to Stop TB as a direct
result of that call. 

"We have to bring in more funding to take quality drugs to the people that
need them most. I am urging you on behalf of the young and the old, the
impoverished and the imprisoned, to join us in efforts to Stop TB. Your
involvement will move us closer to our aim of a world where no one will be
denied access to DOTS" Dr Brundtland concluded.

For further information please contact: In Washington: Dr JW Lee, Tel: (+ 41
79) 217 34 58 or Dr Jacob Kumaresan, Tel: (+ 41 79) 249 35 19. (Both mobile
phones work in Washington).
In Geneva: Dr Ian Smith, Tel: (+41 22) 791 25 36, E-mail smithi@who.int or
Daniela Bagozzi, tel (+41 22) 791 4544); fax (+41 22) 791 4858, E-mail:
All WHO Press Releases, Fact Sheets and Features as well as other
information on this subject can be obtained on the Internet on the WHO
homepage: http://www.who.int/.

Launch of the Global TB Drug Facility

*       The Global TB Drug Facility is a new initiative to be launched on 21
March 2001, to increase access to essential high quality TB drugs, and
rapidly accelerate progress in DOTS expansion to reach the global TB control
targets by 2005. 

*       DOTS - the internationally recommended strategy to control TB -
increases the proportion of people cured of their disease by 20%-50%,
reduces deaths due to TB by 10%-30%, and prevents the emergence of multi
drug resistant TB. Other rewards of DOTS expansion include lower health care
costs, and the profound social and economic benefits of improved public
health. TB drugs are an essential part of the DOTS strategy, yet many
countries still face serious problems in funding, ordering, and distributing
TB drugs.

*       The global targets for TB control are to detect 70% of infectious TB
cases and cure 85% of those detected by 2005. Although nearly 130 countries
had adopted DOTS by the end of 1999, less than 25% of people with TB are
treated with DOTS. Based on current rates of DOTS expansion, the global
targets will not be reached until 2013. The Global TB Drug Facility will
facilitate rapid acceleration in DOTS expansion in order to achieve global
targets by 2005.
*       The Global TB Drug Facility has been developed by the global
partnership to Stop TB (www.stoptb.org). The Stop TB partnership consists of
countries with high burdens of TB, donors, multilateral agencies, non
governmental organizations and technical agencies. The partnership is hosted
by the World Health Organization.
*       The Global TB Drug Facility is hosted by WHO and managed by the
secretariat of the Stop TB partnership

*       The Global TB Drug Facility has the following goals:
(a) Ensure uninterrupted access to quality TB drugs for DOTS implementation.

(b) Catalyze rapid DOTS expansion in order to achieve global TB targets.
(c) Stimulate political and popular support in countries worldwide for
public funding of TB drug supplies.
(d) Secure sustainable global TB control and eventual elimination.

*       By contributing to accelerated DOTS expansion, the Global TB Drug
Facility will have the following impact:
(a) Treat approximately 10 million patients by 2005 and 45 million by 2010.
(b) Avert 25 million TB deaths and prevent 50 million TB cases by 2020.
(c) Prevent the emergence of drug resistance.
(d)Rationalize procurement mechanisms to improve cost-effectiveness of drug
(e) Improve the quality of TB drugs worldwide.
(f) Create a successful model of commitment and cooperation to confront a
global epidemic.

*       The Global TB Drug Facility is not a storage facility, but is a
'virtual' organisation to rapidly and efficiently provide grants 'in kind'
of essential TB drugs to countries in need. The Global TB Drug Facility
reviews applications from countries, and contracts with procurement agents
to provide high quality TB drugs, for use in DOTS programmes.
*       Key principles of Global TB Drug Facility operations include
efficiency, transparency, independence, flexibility, accountability, and
*       The Global TB Drug Facility has received an initial grant from the
Canadian International Development Agency. The Global TB Drug Facility needs
an investment of US$ 250 million between 2001 and 2005 in order to catalyze
national efforts to expand DOTS to achieve the global targets for the year
2005. This estimate is based on DOTS expansion plans for the high TB burden
countries and reasonable assumptions on future drug prices, number of
patients to be treated, and operational costs.
*       The Technical Review Committee of the Global TB Drug Facility is a
group of independent experts in TB control, drug management, and TB
programme management that reviews applications from countries and makes
recommendations on grants to countries. The first meeting of the Technical
Review Committee was held in Geneva from 14-15 March 2000 to review the
first round of applications from countries. 
*       The Technical Review Committee approved grants of drugs to treat
nearly 200,000 TB patients in several countries of Africa, Asia and Eastern
Europe. These drugs will be distributed to the countries by summer 2001.
*       The Technical Review Committee authorised a second round of
applications to be completed by July 2001.
*       The Global TB Drug Facility will be launched by WHO and the Stop TB
partnership in Washington on 21 March 2001, at an event jointly organised by
WHO, Stop TB and the National Council for Elimination of TB. 

For more information on the Global TB Drug Facility please contact the Stop
TB Partnership Secretariat, c/o World Health Organization, 20, avenue Appia,
1211 Geneva, 27 Switzerland, 
http://www.stoptb.org/GDF/Index.htm, E-mail: stoptb@who.int, tel. +(41) 22
791 2385, fax +(41) 22 791 4199.

EMBARGOED UNTIL 11.30 EST, 20 March 2001

*       Twenty-three high-incidence countries account for 80% of all new
cases (the TB80 group). These are Afghanistan, Bangladesh, Brazil, Cambodia,
China, DR Congo, Ethiopia, India, Indonesia, Kenya, Mozambique, Myanmar,
Nigeria, Pakistan, Peru, Philippines, Russia, South Africa, Tanzania,
Thailand, Uganda, Viet Nam, Zimbabwe.
*       There were an estimated 8.4 million new tuberculosis cases in 1999,
up from 8.0 million in 1997; the rise is due largely to a 20% increase in
incidence in African countries most affected by the epidemic of HIV/AIDS. If
present trends continue, 10.2 million new cases are expected in 2005, and
Africa will have more cases than any other WHO Region.
*       Following a decade of successful control, and the consequent
reduction in incidence, Peru fell to bottom place in the league of
high-burden countries in 1999.
*       The number of countries implementing the DOTS strategy (at least in
part) increased by 8 during 1999, bringing the total to 127 (out of 211).
*       The fraction of the world 's population that had access to DOTS
increased slightly from 43% in 1998 to 45% in 1999.
*       Roughly one quarter (23%) of estimated new smear-positive cases were
reported to DOTS programmes in 1999, as compared with 22% in 1998; this is
consistent with the average increment of about 120,000 cases in each year
since 1994.
*       If this trend is maintained, the target of 70% case detection under
DOTS will not be reached until 2013; to get to the target by 2005, DOTS
programmes must collectively recruit at least 300,000 additional
smear-positive cases each year.
*       Almost all (92%) of the progress in DOTS expansion, was made in just
5 countries; 65% of these additional cases were found in 2 countries, India
and South Africa.
*       Treatment success of new smear-positive patients has remained high
under DOTS, and exceeded 80%in the most recent cohort (1998)
*       In 1999, Peru and Viet Nam were still the only high-burden countries
to have exceeded both WHO targets of 70% case detection and 85% treatment
success. However, several other TB80 countries are within reach: they
include Brazil, Cambodia, Kenya, the Philippines, South Africa and Tanzania.
*       A number of smaller countries appear to have declining TB incidence
rates that are linked to high rates of case detection and cure; these
include Cuba, Lebanon, the Maldives, Nicaragua, Oman and Uruguay.
*       China has recently announced preliminary results of a nationwide
survey suggesting a comparatively large reduction in TB prevalence in 13
provinces that have participated in the IEDC TB control project since 1990.
For more information please contact  Dr Mario Raviglione, +(41) 22 791 2663,
Stop TB, c/o World Health Organization, 20, avenue Appia, 1211 Geneva, 27
Switzerland, http://www.who.int/gtb/publications/globrep01/index.html,
E-mail: tuberculosis@who.int, fax +(41) 22 791 4268

Information on World TB Day 2001 events and activities is available from
http://www.stoptb.org/world.tb.day/WTBD_2001/Activities.htm. The World TB
Day pack is available at
http://www.stoptb.org/world.tb.day/WTBD_2001/WTBDpack.htm. To order
materials please contact the CDS Documents Centre at
mailto:desplobainsm@who.int. For further information on World TB Day, please
contact the Stop TB Partnership Secretariat at stoptb@who.int. World TB Day
materials were produced by the IUATLD and the Stop TB Partnership

World TB Day Alert is a series of information bulletins issued every few
days in the run-up to World TB Day. Each message is intended to alert people
to the number of days left to 24 March 2001 and advise practical steps to
ensure the success of the global campaign for "DOTS: TB Cure for All".
'Stop TB' - a global movement to accelerate social and political action to stop 
the spread of tuberculosis around the world.
For further information please contact the Stop TB Secretariat at stoptb@who.int
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Mail administrative requests to `majordomo@usa.healthnet.org'.
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