Joint Opening of South-East Asia Regional Meeting of Partners for TB Control and 11th Meeting of the Stop TB Coordinating Board, Address, 27-30 November 2006, Jakarta, Indonesia.

Address By Dr Samlee Plianbangchang Regional Director, WHO South-East Asia At Joint Opening of South-East Asia Regional Meeting of Partners for TB Control and 11th Meeting of the Stop TB Coordinating Board Jakarta, Indonesia 27-30 November 2006 Joint Opening of South-East Asia Regional Meeting of Partners for TB Control and 11th Meeting of the Stop TB Coordinating Board 27-30 November 2006 Jakarta, Indonesia Address By DR SAMLEE PLIANBANGCHANG REGIONAL DIRECTOR, WHO SOUTH-EAST ASIA Your Excellency, Dr (Mrs) Siti Fadilah Supari, Minister of Health, Government of Indonesia; Distinguished Partners; Honourable Members of the Coordinating Board; Distinguished Guests; Ladies and gentlemen: Despite the progress made over the past decade, TB continues being a major cause of death in countries of the South-East Asia Region. The World Health Assembly in 2000 declared that by the year 2005 all endemic countries in the world should achieve two important targets in TB control. These targets are: 70% case detection, and 85% treatment success. All countries in this Region have achieved and sustained 85 per cent treatment success since 2003. However, by the end of last year, the overall case detection rate was still 64%. Nonetheless, all countries are moving steadily towards reaching both targets. 2 To ensure success in TB control, we have also set a fresh target under the Millennium Development Goals. This target is to halt and reverse the trend of tuberculosis by 2015. This will be attained by sustaining what has already been achieved and by continued reduction of both prevalence and mortality rates. However, data from the control programmes show a steady increase in TB case notifications. While this certainly reflects better diagnosis and reporting, it is a worrying situation. The majority of these cases continue to be among the younger age groups. This trend reflects ongoing transmission of TB in the community. In addition, we can see the re-emergence of TB which is linked to several other factors. Such as the spread of HIV that has perpetuated TB resurgence in this Region. We have, therefore, to seriously take care of those factors while developing TB control programmes. The robust strategy for TB control, well known as DOTS, has paid us good dividends, until now. However, over the years, since the DOTS strategy was first introduced, there has been a significant environmental change, and many new challenges in TB control have emerged. Therefore, a new Stop TB strategy, 2006-2015, was launched earlier this year. 3 The key issue before us now is whether we have the means to implement this strategy successfully over the next 10 years. We have only limited resources, and we have to make the best use of whatever is available with us. We have to utilize the existing health infrastructure and facilities in the most efficient manner. We have to develop mechanisms to effectively deliver services to where these are really needed. One of the key concerns is to reach the unreached; the poor, underserved, and marginalized. We need to see how best to work with other sectors, so that there will be synergy in our efforts. This is important, especially since several socio- economic determinants are involved in the occurrence of the disease. I am pleased with the progress made in developing private / public partnerships for TB control. This approach will take us a long way in ensuring efficient delivery of needed services. Operational research to provide evidence for the improvement of programme management is necessary. Tuberculosis control is not an issue that can be successfully tackled by the health sector alone. It should always be kept in mind that the spread of TB is contributed by several social and economic factors. 4 Significant reduction of TB in countries is clearly linked to several conditions, such as: Improved standards of living; better nutrition; better education; heightened community awareness; and increased demand for health services. Tuberculosis control, therefore, requires a strong multi-sectoral approach, which has to be pursued through effective partnerships. We greatly appreciate the support to TB control provided through bilateral, multilateral or private initiatives. These include the Global Fund and many others. Countries must ensure that this support is efficiently utilized to build their own capacities. We have to ensure that our plans to alter the course of TB, TB/HIV and drug-resistant TB are effectively implemented in the years ahead. We must look forward towards a long-term sustainable development in countries. Increased investments in health care, especially by the countries concerned, will take us a long way in ensuring this sustainability. We must engage in leveraging resources, not only within the health sector, but also elsewhere. Other ministries and departments, NGOs, civil society, business enterprises and industry have much to contribute to TB control. 5 The shift from a purely medical model to an inter-sectoral process, is essential for overcoming the many challenges faced in TB control. Without this approach, our goal of a tuberculosis-free world will remain illusive. Let us now resolve that one day, everywhere in the world, TB will be part of history; But, for this to happen, we must be prepared to work with greater enthusiasm in the years ahead. Now, let us look forward to productive deliberations and successful outcomes from these two meetings.