A decade after declaring tuberculosis a global emergency, the World Health Organization yesterday marked World Tuberculosis Day by announcing what it presented as a milestone in global efforts to fight the disease.

More than 10 million patients, 90 percent of whom live in developing countries, have been successfully treated under the directly observed therapy, short-course, or DOTS, treatment, the WHO said, adding that the spread of the disease has slowed to a growth rate of 0.4 percent per year.

This year's WHO Global Tuberculosis Control Report, released today, indicates the number of countries that have adopted the DOTS strategy has grown to 155.  More than 60 percent of the world's population now has access to DOTS services.

"The treatment and cure of so many people under DOTS has saved millions of lives and is slowing the spread of infection," said WHO Director General Gro Harlem Brundtland. "But now we must accelerate our efforts.  With additional funding for TB control programs, especially in the 22 high-burden countries that account for 80 percent of global cases, we could expect to see a worldwide reduction in the sickness and death caused by TB within three years."

The WHO said the tuberculosis epidemic is growing unabated in sub-Saharan Africa, where it is closely linked to HIV/AIDS and poverty, and in many countries of the former Soviet Union, where it is exacerbated by poverty and social disruption.  In some sub-Saharan countries with high HIV rates, tuberculosis rates have quadrupled since the 1980s and threaten to overwhelm well-established control programs, the agency said.

"TB and HIV have become intertwined epidemics, increasing their devastating impact on communities worldwide," said Peter Piot, executive director of the Joint U.N. Program on HIV/AIDS.  "Effectively treating TB will not solve the AIDS crisis, but will save lives and ultimately reduce the burden of AIDS on societies."

The WHO and Stop TB Partnership members -- including the World Bank, the U.S. Agency for International Development, the Canadian International Development Agency, the British Department for International Development, Japan and the Netherlands -- are closely cooperating to meet funding gaps in the Global Plan to Stop TB for 2001-05, the WHO said.  They are also demonstrating how tuberculosis and HIV workers can collaborate to strengthen DOTS for people with HIV, to diagnose tuberculosis earlier and to provide preventive therapy, the agency said.  High-burden countries are also said to be putting considerable funding and expertise into defeating tuberculosis, with verifiable results.

The WHO cited efforts in India, where more than 1 million patients have been treated under DOTS since 1998 and 50,000 new patients start on treatment every month.  In China, 1.3 million people have been treated under DOTS over the last decade, and 90 percent of them have been cured, the WHO added.  Vietnam and Peru have already exceeded the global tuberculosis control targets for 2005 by identifying better than 70 percent of all cases and curing more than 85 percent of them, the agency said, adding that Myanmar and Cambodia are within reach of the 2005 targets (WHO release, March 25).

Tuberculosis rates have fallen in El Salvador because of early detection and treatment programs, Vice Minister of Health Herbert Betancourt said yesterday.  He added that 85 percent of treated patients have been cured but warned that the risk of death is doubled among patients who are also suffering from HIV/AIDS (Ivette Amaya, El Diario de Hoy, March 25, UN Wire translation).