title: Scaling up interventions to achieve global tuberculosis control: progress and new developments.
abstract: 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 offer 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.
authors.affiliation: STOP TB Department, WHO, Geneva, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Raviglione
authors.forename: Ben
authors.initials: B
authors.lastname: Marais
authors.forename: Katherine
authors.initials: K
authors.lastname: Floyd
authors.forename: Knut
authors.initials: K
authors.lastname: Lönnroth
authors.forename: Haileyesus
authors.initials: H
authors.lastname: Getahun
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Migliori
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harries
authors.forename: Paul
authors.initials: P
authors.lastname: Nunn
authors.forename: Christian
authors.initials: C
authors.lastname: Lienhardt
authors.forename: Steve
authors.initials: S
authors.lastname: Graham
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Chakaya
authors.forename: Karin
authors.initials: K
authors.lastname: Weyer
authors.forename: Stewart
authors.initials: S
authors.lastname: Cole
authors.forename: Stefan H E
authors.initials: SH
authors.lastname: Kaufmann
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D035843:Biomedical Research / Q000639:trends; D003140:Communicable Disease Control / Q000379:methods; D003153:Community Health Services / Q000458:organization & administration; D005381:Financing, Organized; D005544:Forecasting; D014943:Global Health; D015658:HIV Infections / Q000150:complications / Q000401:mortality; D006801:Humans; D015994:Incidence; D015995:Prevalence; D012944:Social Support; D014376:Tuberculosis / Q000150:complications / Q000401:mortality / Q000517:prevention & control*; D032581:Tuberculosis Vaccines; D018088:Tuberculosis, Multidrug-Resistant / Q000401:mortality / Q000517:prevention & control
chemical_list: D000995:Antitubercular Agents; D015415:Biomarkers; D032581:Tuberculosis Vaccines