Strengthened the capacity of health workforce to cope with tuberculosis

29/03/2024 09:25 AM

Since the World Health Organization declared tuberculosis (TB) to be a global health emergency in 1993, global efforts to address TB have become more prominent, and worldwide TB incidence and mortality rates have fallen. In Viet Nam, Prime Minister Pham Minh Chinh recently ordered efforts to be exerted to enhance the tuberculosis (TB) prevention and control efforts.

In 2022, there were an estimated 10.6 million new cases of TB globally, including 671,000 new cases in people living with HIV. In response to the persistent challenges related to TB, including drug-resistant TB, the U.N. General Assembly has held two high-level meetings on TB – in 2018 and 2023 – to discuss these challenges and examine progress toward global goals, including ending the epidemic by 2030.

Tuberculosis, an infectious disease caused by bacteria, is a leading cause of death worldwide, despite being preventable and often curable. Approximately a quarter of the world’s population has “latent” TB, meaning they have been infected by TB bacteria but are not yet ill with the disease and cannot transmit it ; about 5-10% of people infected with TB will, at some point during their lifetime, develop symptoms of “active” TB, which can be spread to others. When a person with active TB coughs, sneezes, or spits, the bacteria spreads into the air where it may be inhaled by and infect others. TB is found all over the world, though the vast majority of TB cases are concentrated in a handful of countries in Southeast Asia, Africa, and the Western Pacific region. People in resource-poor settings, especially those living in poverty or in crowded living conditions with poor ventilation , are disproportionately affected.

The End TB Strategy, the internationally-recognized strategy for ending the TB epidemic, outlines interventions aimed at decreasing TB-related morbidity, death, and transmission. They include:early diagnosis of TB via sputum-smear microscopy,

treatment (usually a six-month course of antibiotics for drug-sensitive TB) and patient support for all people with TB, scaled-up diagnosis and management of MDR- and XDR-TB, systematic screening for and management of TB among people living with HIV and others in high-risk groups, preventive treatment, including TB preventive treatment (TPT) and vaccination20 for high-risk groups, and research and development (R&D) of new tools.

Other interventions include the development of policies and systems that support TB activities, such as improved standardized data collection, quality assurance and rational use of drugs, and monitoring and evaluation of outcomes; sustained political and financial commitment to TB efforts; health systems strengthening; and increased health workforce capacity to respond to TB.

Since the 1993 declaration of TB as a global health emergency by WHO,21 major global TB goals have most recently been set through the following: Adopted in 2015, the Sustainable Development Goals (SDGs) aim to end the TB epidemic by 2030 under SDG Goal, which is to “ensure healthy lives and promote well-being for all at all ages.”

Since 1990s, its efforts to address TB have grown, and now the U.S. is one of the largest donors to global TB control.

U.S. TB activities reach approximately 50 countries (including at least 20 of the 30 high burden countries where most new cases are occurring), and focus on preventing, detecting, and treating TB, including drug-resistant TB, as well as research and development.

U.S. funding for global TB efforts was $406 million in FY 2023, up from $233 million in FY 2013. Additionally, the U.S. is the largest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), which has approved nearly $10 billion in funding for TB programs worldwide.

In Viet Nam, Prime Minister Pham Minh Chinh recently ordered efforts to be exerted to enhance the tuberculosis (TB) prevention and control efforts. His recent dispatch in this regard said TB prevention and control activities have achieved commendable results in recent years. On an annual basis, over 100,000 TB patients are detected, with a treatment success rate exceeding 90% and the rate of detection quickly recovering after the COVID-19 pandemic.

However, the annual death toll remains high, at approximately 13,000, while many cases within the community remain undetected. According to the World Health Organization (WHO)’s 2023 report, the TB situation in Vietnam is still severe, ranking 11th out of the 30 countries burdened with the disease and the highest drug-resistant TB rate globally.

The PM urged ministries, sectors, central and local authorities to thoroughly implement the national TB prevention and control strategy. Communications work is considered a long-term and important task for the entire political system from central to grassroots levels, with the healthcare sector being the cornerstone.

Among the several tasks assigned by the leader, chairpersons of the People's Committees of centrally-run localities are instructed to strengthen the capacity of the healthcare system in diagnosing and treating the disease, while effectively implementing community-based TB prevention and control measures.

Meanwhile, the Minister of Health is requested to finalise and issue guidelines for the detection of TB, latent TB, and some respiratory diseases in the community and healthcare facilities. Additionally, there is a need to enhance international cooperation and ensure domestic resources, especially medicine.