A month later, the World Health Organisation (WHO) announced that thanks to an unprecedented international collaboration, the virus that had led them to issue a global health alert over a new and deadly form of pneumonia, had  been conclusively identified. The SARS virus (Severe Acute Respiratory  Syndrome), which by then had notched up over 3,000 cases and 159 deaths, was  identified just five weeks after SARS was first reported - testament to what  scientists can achieve with adequate organisation and investment!

Let's hope, despite its quick identification, the SARS virus doesn't prove to  have as much longevity as the tubercle bacillus, which nineteenth century  uber-scientist, Robert Koch, identified in 1882 as the cause of tuberculosis (TB). Some one hundred and twenty-one years later this particular severe respiratory disease still kills over two million people every year and causes  illness in around eight million - even though there is cheap and effective treatment for it.

Initial TB treatment targets have fallen short

2003 marks the tenth anniversary of TB being declared a global health emergency by the WHO. In 1994, world health leaders established a transferable TB control programme called DOTS (Directly Observed Therapy Short-course). Still the internationally recommended response to TB, the DOTS programme recommends five priorities in fighting the spread of TB:

• Government commitment to sustained TB control
• Appropriate case detection systems
• Standardised short-course chemotherapy, including direct observation of  treatment
• Adequate supply of drugs
• Standardised recording and reporting systems.

DOTS programmes have since been used to treat 10 million people with TB, the  vast majority in developing countries where the burden of TB is greatest. Though more WHO member states are added to the list of DOTS-compliant countries each year, the most recent report from the WHO Global Tuberculosis Control Programme suggests previously agreed targets for the detection and containment of the disease have not been met.

WHO's goals for 2005 were twofold: to ensure that 70 per cent of TB cases  would be detected, and that 85 per cent would be treated successfully. In fact,  just 32 per cent of the estimated incident cases of infectious TB were notified to the WHO by DOTS programmes during 2001.

More alarming has been the rate of success in detecting cases. This has not  improved significantly since 1995 when DOTS surveillance first began in earnest. Although the global average for treatment achieved was 82 per cent, this fell  short in high-risk areas like Africa. Without substantial improvement, it's  estimated WHO's original TB targets will not be met before 2013.

Dr Jong Wook Lee, Director-General nominee of WHO recently described the effect of HIV on latent TB infection: "Like putting a match to petrol."

Some successes where TB and HIV are linked

Interestingly, it's the changes in global access to medicines, which have  been brought about by activity in the broader HIV community, which now seem likely to have the greatest bearing on the future control of TB.

In a matter of years, attitudes and action on treatment access have changed  dramatically, encouraged by political pressure, and supported by state,  corporate, institutional and private donors.

The Global Drug Facility, established in 2001 by the Stop TB Partnership, has  reduced the cost of TB drugs by 30 per cent to less than $10 for a full course of treatment, ensuring people in developing countries have access to adequate treatment.

And the Global Fund to Fight Aids, Tuberculosis and Malaria has so far allocated nearly $250 million in its first two years to TB control programmes. This includes a sizeable chunk given to India in the hope that their recent  successes can be maintained. In India, more than one million people have been treated for TB under DOTS programmes since 1998, and some 50,000 people are started on TB treatment there every month. So there is some hope.

This article originally appeared in Positive Nation Issue 91