Every year, more than 9 million people are affected by tuberculosis (TB) and 1.8 million die from it. Developing countries are heavily affected. The highest rates per capita are in Africa, but the largest numbers are in Asia, with nearly 60% of the global burden. TB associated with HIV/AIDS is a huge challenge in Africa and multidrug-resistant TB (MDR-TB) is frequent in the former USSR and parts of Asia.
The United Nations Millennium Development Goal (MDG) related to TB control aims to halt and begin to reverse the incidence of TB by 2015, and the STOP TB Partnership targets elimination of TB as a major public health problem worldwide by 2050.
The World Health Organization (WHO) has developed a six-point Stop TB Strategy to reach the global targets: (i) pursue high-quality DOTS expansion and enhancement; (ii) address TB/HIV, MDR-TB and other challenges; (iii) contribute to strengthening health systems; (iv) engage all care providers; (v) empower patients with TB; and (vi) enable and promote research.
Progress has been made to date toward achieving the global targets. Compared to performance of control programmes in the mid-1990s, up to 6 million human lives have been saved through the implementation of DOTS, later enhanced to the Stop TB Strategy, since 1995. The global incidence of TB has peaked in 2004, resulting in an earlier achievement of the MDG related to TB control. However, the decline since then has been less than 1% per year, which is insufficient to seriously target elimination by 2050.