Did we reach the 2005 targets? Will we achieve the Millennium Development Goals?

World Health Assembly 1991 "…attain a global target of cure of 85% sputum-positive patients under treatment and detection of 70% of cases by the year 2000"

Targets for global TB control MILLENNIUM DEVELOPMENT GOALS "to have halted and begun to reverse incidence.." Implementation (DOTS) Target year Case detection 70% 2005 Treatment success 85% 2004/5 Impact Prevalence 50% of ≈ 300/100K 2015 Deaths 50% of ≈ 30/100K (<1m) 2015 Incidence <1 per million 2050

45% 37% 32% 28% 24% 22% 18% 16% OVER 26 MILLION TB PATIENTS TREATED UNDER DOTS WORLDWIDE CASE DETECTION (%) 53% WHO target 59%

Trends in case notification rates in Viet Nam, total Annual percentage change Men WomenTotal

TB control in India No state shows marked decline in notification rate attributable to lower transmission Best performers show steady rise 1.1% 9.6% 3.9% Reported smear+ cases per 100K KeralaW BengalRajasthan

Did we reach the 2005 targets? No, but…  59/ /85 = a near miss  Over 26m patients treated in 11 yr  Target detection in ≈ 57 countries  Target cure in ≈ 60 countries  Both targets reached in W Pacific  On threshold of falling incidence

Will we achieve the Millennium Development Goals? Yes, if…  Global Plan turned into robust, funded, country-owned plans to implement the Stop TB Strategy  Stronger monitoring & evaluation to guide action, and a deeper understanding of impact of TB control