Abstract
The public health problem of tuberculosis (TB) and access issues related to TB medicines
A serious threat to public health worldwide, TB caused 1.3 million deaths in 2012 alone. Although largely curable, TB remains a leading cause of death in people co-infected with HIV and among women of reproductive age. The burden of TB is also borne disproportionately by the most vulnerable populations: the highest TB death rates are in low-income countries, and TB is one of the top 10 causes of death in children. Access to appropriate, quality-assured (QA) medicines—critically lacking in so many resource-limited settings—is vital for the control of TB.
In 2012, about 3 million people with active TB—one third of all new cases—were not reported and likely not treated according to World Health Organization (WHO) recommendations. Access for TB patients infected with drug-resistant strains is even lower: in 2012, about 77 300 patients (of an estimated 450 000 total) were enrolled on second-line treatment. Access to TB care for children is poor: recent studies have reiterated assumptions that approximately 1 million children may need TB treatment each year, yet only 349 000 paediatric TB cases were reported to national programmes in 2012. And even when paediatric TB is detected and treated, available formulations of TB medicines are inappropriate for children and not aligned with WHO recommendations.