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

2. 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"

4. 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

6. 45% 37% 32% 28% 24% 22% 18% 16% OVER 26 MILLION TB PATIENTS TREATED UNDER DOTS WORLDWIDE CASE DETECTION (%) 53% WHO target 59% 94 95 96 97 98 99 01 02 03 04 05

12. Trends in case notification rates in Viet Nam, 1997-2004 -8 -4 0 4 8 15-2425-3435-4445-5455-6465+total Annual percentage change Men WomenTotal

14. 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% 20 30 40 50 60 70 200020012002200320042005 Reported smear+ cases per 100K KeralaW BengalRajasthan

21. Did we reach the 2005 targets? No, but…  59/70 + 84/85 = 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

22. 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