About a century after Koch's discovery of the TB bacilli the tuberculosis epidemic which had appeared to be under control was again recognized as a major global health threat. The decline in the epidemic in this century had been largely through the improved living standards and, eventually, the availability and use of effective antibiotics. While tuberculosis gradually disappeared from the health agenda in the western world it remained a big killer throughout the century and in 1992 an estimated 2.7 million TB deaths occurred; 30 million will die from TB during the 1990s if current trends are not reversed. The annual number of new cases will increase from 7.5 million estimated in 1990 to more than 10 million in the year 2000. The main factors for this increase are demographic forces, population movements, the HIV epidemic and increasing drug resistance. The impact of the HIV epidemic is already felt in many sub-Saharan African countries and now threatens Asia where almost two-thirds of the world's TB infected population live and where HIV is spreading. Tuberculosis has also reemerged as a major public health problem in industrialized countries due to international migration, the breakdown of health services, including TB services etc. The control of the epidemic can only be through a concerted action to reinstate TB as priority among health concerns, reflected in national and international resources. A coalition of public and private supporters must be mobilized to support the effort to fight the disease. Governments, non-governmental organizations, the business community, refugee organizations, medical institutions, and other UN agencies are invited to join with WHO in this effort.
PIP: Robert Koch discovered the tuberculosis (TB) bacilli about a century before the epidemic that had appeared to be under control was again recognized as a major global health threat. The decline in the epidemic in this century had been largely through improved living standards and, eventually, the use of antibiotics. While TB gradually disappeared from the health agenda in the Western world, at the end of the 20th century TB is the most important cause of death among infectious diseases. In 1992 an estimated 2.7 million TB deaths occurred, and the global TB death rate was about 50/100,000, with more than 95% of deaths in developing countries. 30 million will die from TB during the 1990s if current trends are not reversed. The annual number of new cases will increase from 7.5 million estimated in 1990 to more than 10 million in the year 2000. The main factors for this increase are demographic forces, population movements, the HIV epidemic, and increasing drug resistance. The impact of the HIV epidemic is already felt in many Sub-Saharan African countries and now threatens Asia, where almost 2/3 of the world's TB infected population live and where HIV is spreading. One third of the world's population had been infected by TB in mid-1993 and more than 5 million of these were dually infected with HIV and TB. TB has also reemerged as a major public health problem in industrialized countries owing to international migration and the breakdown of health services including TB services. In the US between 1985 and 1991 the number of reported cases increased by 20%, causing 39,000 more cases than expected. Similarly, in eastern Europe and the former Soviet Union the TB situation is deteriorating. In western Europe the low rates of TB have been offset by increasing incidence among foreign born residents. The epidemic can only be controlled through concerted national and international action.