P2 08 TB Poverty WPR

TB and poverty agenda in WPR: 

TB and poverty agenda in WPR WHO/WPRO Stop TB

Percentage of population living below US$1 a day: 

Percentage of population living below US$1 a day

TB and poverty: 

TB and poverty 98% of 1.8 million TB deaths per year in developing countries. TB mortality rate 3 X higher in rural poor China than in more developed urban areas. ARI in the Philippines 2.5 times higher among urban poor than urban non-poor. Mexico and South Africa: no difference in socio-economic status between TB patients and non TB patients living in the same community

Slide4: 

TB incidence weakly related to social and economic variables: infant mortality 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 Infant mortality rate 1991 (log-transformed) estimated TB incidence (log-transformed) AF AS CA EE SA US WP ME WE Series10

TB prevalence among poor and non-poor, Philippines: 

TB prevalence among poor and non-poor, Philippines Source: Philippines NTP, 2000

S(+) prevalence rates: China: 

S(+) prevalence rates: China Source: World Bank, 2000

TB and poverty in China (1990): 

TB and poverty in China (1990)

Prevalence of s(+) TB by ethnic group in China in 2000: 

Prevalence of s(+) TB by ethnic group in China in 2000 Source: Ministry of Health of China, 2000

Poverty and TB: 

Poverty and TB Vulnerability to severe disease and death from TB Delaying access to care Inhibiting treatment adherence Overcrowding associated with infection and outbreaks of TB TB burden higher where poverty is higher

S(+) TB notification rates versus income in Vietnam provinces: 

S(+) TB notification rates versus income in Vietnam provinces Source: Ministry of Health of Vietnam, 2003

TB notification rates and ethnic groups in Vietnam provinces: 

TB notification rates and ethnic groups in Vietnam provinces Source: Ministry of Health of Vietnam, 2003

TB notification rates and poverty in Cambodian provinces: 

TB notification rates and poverty in Cambodian provinces Source: Ministry of Health of Cambodia, 2002

TB notification and poverty: 

TB notification and poverty TB notification is lower where poverty is higher in Vietnam TB notification is at a similar level between poorer and less poor areas in Cambodia

Poverty and TB Case Detection Rate: 

Poverty and TB Case Detection Rate Poor compared to non-poor communities: Higher TB prevalence Lower or similar case notification rates  Lower TB Case Detection Rate in poorer areas

Expansion may not be enough: 

Expansion may not be enough ‘The Missing Cases’ Detection Coverage

Progress in 2004Objective 1: Reaching the 70/85/100 targets: 

Progress in 2004 Objective 1: Reaching the 70/85/100 targets *2004 figures are for high burden countries which account for 90% of the TB burden

Impact of scenariosD70 and Dincreased on prevalence: 

Impact of scenarios D70 and Dincreased on prevalence Decline in prevalence 0 50 100 150 200 250 300 1990 1995 2000 2005 2010 2015 2020 rate per 100,000 D70 Dincreased

Impact of scenariosD70 and Dincreased on mortality: 

Impact of scenarios D70 and Dincreased on mortality

Thank you!: 

Thank you!