Tuberculosis (TB) in the UK in 2006

Tuberculosis (TB) –- which remains the biggest killer of people with HIV worldwide –- has doubled in frequency in London since the late 1980s, according to a report from the Health Protection Agency released on March 24th, World TB Day.

In some London boroughs, people with active TB are now as common as people with HIV are in the UK. The old ‘white plague’, which kills 1.7 million people a year, infects about a third of the world’s population.

People with HIV who have TB are 50 times more likely to develop the active disease, and it causes one in 7 AIDS deaths worldwide. It also develops at higher CD4 counts than other opportunistic infections do.

The Director-General of the World Health Organisation, Dr Jong-Wook Lee, has said: "When HIV hits a pool of latent TB infection it is like putting a match to petrol.”

The HPA report shows that between 2003 and 2004 –- the last years we have compete figures for -– TB cases in the UK rose 5%, from 6,837 to 7,167 cases.

This is against a global background in which, due to improved control programmes, TB prevalence has fallen in every continent except Africa.

The UK increase has been concentrated almost entirely in London. Active cases of TB doubled from 20 cases per 100,000 people in 1988 to 40 cases in 2003, and the proportion of TB from London has increased from 28% of all TB cases in England and Wales in 1987 to 45% in 2003. In two London boroughs, Brent and Newham, nearly one in 1,000 people has active TB.

The National Institute for Health and Clinical Excellence has issued new guidelines to screen people for TB on entry to the UK, and also homeless people (cold, damp and crowding exacerbate TB).

Meanwhile, the World Health Organisation has reported that a growing percentage of TB cases are milt-drug-resistant, which means they don’t respond to the two most frequently used drugs in TB combination therapy, isoniazid and rifampicin. MDR-TB cases in the USA increased last year by 13% to 1.2% of all cases tested.

Now health chiefs are worried that we are even sighting the emergence of XDR-TB – ‘extensively drug-resistant TB’, which means that it’s become resistant to some of the second-line drug, such as ciprofloxacin, used to treat MDR-TB. The worst affected country was South Korea, where 15% of all MDR-TB was in fact XDR-TB.

Meanwhile, a US-Danish non-profit initiative, the Aeras Global TB Vaccine Foundation, has inaugurated the first laboratory dedicated to improving the TB vaccine. The current BCG vaccine was invented 80 years ago and is frequently ineffective, especially in people with lowered immunity. Aeras has received a $82.9 million grant from the Bill and Melinda Gates Foundation for its work.

The Global Plan to Stop TB 2006 - 2015

The Global Plan to Stop TB 2006 - 2015 is a comprehensive assessment of the action and resources needed to implement the Stop TB strategy and make an impact on the global TB burden.

• View the full Global Plan to Stop TB 2006 - 2015
• The Executive Summary English, Français, Español
• The Foreword to the plan by Irene Koek (Chair, Stop TB Partnership Coordinating Board) and Ernest Loevinsohn (Emeritus Chair, Stop TB Partnership Coordinating Board)
• The Preface by Dr LEE Jong-wook, Director-General, World Health Organization
• The Statements of Suppport by Emile Bongeli Yeikelo ya Ato, Minister of Health, Democratic Republic of Congo, Hilary Benn, United Kingdom Secretary of State for International Development and Andrew Natsios, Administrator, U.S. Agency for International Development
• The Introduction explains the rationale for the Plan and outlines how the Plan is structured.
• The Steering Committee of the Global Plan to Stop TB 2006 - 2015
• Click here to learn more about the development of the Global Plan

The UK's Department for International Development (DFID) continues to lead the world on eradicating diseases like HIV, TB and malaria. DFID is a key donor to the Global Fund to fight AIDS, TB and Malaria; supports the StopTB Partnership, provides core funding to the World Health Organisation, as well as direct support to a number of countries to slow down and reverse the spread of TB.

Read more about DFID's work on TB here.