London tuberculosis rates now at Third World proportions

- Public health experts call for TB to be health priority for Europe

Today at a London parliamentary briefing, health and development experts warned of worryingly high rates of tuberculosis in the capital and described a wave of TB across western Europe linked to globalisation - and increased travel and population movement - which is reaching epidemic proportions.

Addressing Westminster MPs at a briefing by the Stop TB Partnership, speakers from the World Health Organization (WHO), the Department for International Development (DFID), TB Alert and Results UK said that the increase in TB in industrialised countries was symptomatic of a global increase in the epidemic.

Public health experts presented data on TB incidence for Western Europe and pointed to places in Europe -- including several London boroughs -- where TB rates exceeded national rates in China and rates in parts of India and Africa. TB should be one of the highest priorities on the health agenda for Europe, they said.

Dr Chris Dye of WHO said:

"London is a snapshot of the global epidemic. What we are witnessing here and in other European capitals reminds us of the 'globalisation' of disease - so long as there is TB in the world, no one can feel completely safe. TB is on the increase in Western Europe. It is out of control in many countries in eastern Europe and in the Newly Independent States where rates of multidrug-resistant TB -- a man-made phenomenon -- are among the highest in the world."

Paul Sommerfeld of UK-based charity TB Alert said:

"Rates of TB in Britain are at a ten-year high. We need to act locally to resolve this worldwide problem. TB rates in London have doubled in 15 years with rates of TB in some London boroughs now at Third World proportions and cases of its most dangerous drug-resistant form on the rise. Already 50 people a week develop TB in London and TB in Britain has increased by more than 20 per cent in the last decade."

TB in urban Britain has increased by more than 20 per cent in the last decade and in London by 80 per cent. The rate of TB in London is 40 per 100,000 -- three times the national average of 13 per 100,000, according to the Public Health Laboratory Service and WHO. Rates in the capital are at their highest for a decade. Boroughs with the highest rates are Brent (116.5/100.000), Newham (104.0 per 100,000) and Hackney (87.2 per 100,000). Last year there were 7,300 cases in the UK as a whole. More than 3,000 were in London.

The highest rates in Western Europe are in Portugal (42 per 100,000) and Spain (20 per 100,000). These rates compare with 113 per 100,000 in China and 64 per 100,000 in Brazil. TB is the world's greatest infectious killer of women of reproductive age and the leading cause of death among people with HIV/AIDS. Globally more than 23 000 people develop active TB and almost 5 000 die from the disease every day -- and the numbers are rising.

Case story, Minister for Pensions Ian McCartney MP, who contracted TB in 1992 urged agencies in the UK to make TB a priority:

"Local action is critical to controlling this modern plague. Like millions of others in Britain, I believed my lifestyle cocooned me from many of the dangers to which those in less fortunate circumstances are subject. I was wrong. Back in 1992 as a Member of Parliament for a northern constituency ... I was diagnosed as suffering from TB. I felt angry and frustrated that a disease from the past was staring me in the face."

"The culture of TB politics has to be changed. We need to boost the levels of funding and make TB one of the highest priorities on the health and development agenda in Europe," he said. Approximately two thirds of funding comes from governments of the countries with a high TB burden; five per cent comes from donor countries like Britain.

Sally Keeble MP from DFID said:

"TB is a major threat to global health, prosperity and social stability. Ninety-two per cent of all TB cases and TB-related deaths occur in low and lower-middle income countries. This requires a global response. DFID is committed to this global effort and to supporting the Stop TB Partnership in its vital co-ordinating role."

At the briefing, officials identified the funding shortfall for TB as US $3.7 billion against a total of US $9.1 billion to meet the targets set by the Stop TB Partnership in their Global Plan to Stop TB. These are to identify 70 per cent of all infectious TB cases and to cure 85 per cent of those cases by 2005. If the targets are met by 2005, and effective TB treatment is maintained, the burden of TB can be substantially reduced by 2010.

Note to editors

1. The Stop TB Partnership was established by WHO in 1998 as a broad-based social movement to combat TB. Over 200 organisations are now signed up to the Partnership. In 2001 it launched the Global Plan to Stop TB and set targets to eliminate the disease. These are to identify 70 per cent of all people with infectious TB and ensure that 85 per cent of those detected are successfully treated, by the end of 2005, using the Directly Observed Treatment Short-Course (DOTS) strategy.

2. This week the British Thoracic Society will address some of the other factors contributing to the increase in rates in the UK at its annual adult lung disease conference (Queen Elizabeth Hall, Westminster (4-6 December 2002).

SOURCE Stop TB Partnership