Reasons Why WHO Declared TB as a Global Emergency
In spite of huge magnitude of TB problem, TB has been neglected in the past few decades.
As a result, out of the total ODA budget in 1990, only 1.5% were spent for Intectious diseases control, and only its 5% used for TB control.
New obstacles hindering smooth implementation of TB control are now coming out.
If current situation continues, another 10 million new TB cases and 1 million TB death will be seen in the coming decades.
Why TB Had Been Neglected?
Nature of TB
TB is a chronic disease resembling iceberg floating on the sea.
Difficult to know the real magnitude of the problem.
Illusion that all TB problems were solved.
Success of TB control in industrialized countries produced the illusion. As a result;
TB infrastructures were weakened.
Budget for TB control and research was reduced, and it had become difficult to recruit young TB specialist.
TB attacked mostly vulnerable persons and countries.
Their voices were not heard by policy makers.
Reasons of Failure in TB Control in Developing Countries
Slow economic development and rapid expansion of the population.
Decline of TB by improving socio-economic conditions could not be expected.
Poor allocation of budget for health care including NTP.
Weak health infrastructure and slow development of PHC.
Shortage of health manpower and institutions.
NTP is to be integrated into PHC, and NTP can not jump over development of PHC.
Often is was instructed "It should be ...", but not "How to do ...".
Why TB Problems Have Been Given Higher Priority Recently?
Increase of TB with HIV epidemic: TB has increased first in Africa and some parts of US, then in South- East Asia.
Recognition of real magnitude of TB problem.
Success of TB control in some developing countries by using currently available technologies: Success of SCC in East Africa.
TB control is cost-effective: Analysis of success story provided evidences of cost-effectiveness of TB control.
Increase of MDRTB: Worry for loss of efficacy of current technologies.
