1. TB and poverty agenda in WPR WHO/WPRO Stop TB

2. World Health Organization Percentage of population living below US$1 a day

3. World Health Organization TB and poverty 98% of 1.8 million TB deaths per year in developing countries. TB mortality rate 3 X higher in rural poor China than in more developed urban areas. ARI in the Philippines 2.5 times higher among urban poor than urban non-poor. Mexico and South Africa: no difference in socio- economic status between TB patients and non TB patients living in the same community

4. TB incidence weakly related to social and economic variables: infant mortality 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 1.52.02.53.03.54.04.55.05.5 Infant mortality rate 1991 (log-transformed) estimated TB incidence (log-transformed) AF AS CA EE SA US WP ME WE Series10

5. World Health Organization TB prevalence among poor and non-poor, Philippines Source: Philippines NTP, 2000

6. World Health Organization S(+) prevalence rates: China Source: World Bank, 2000

7. World Health Organization TB and poverty in China (1990)

8. World Health Organization Prevalence of s(+) TB by ethnic group in China in 2000 Source: Ministry of Health of China, 2000

9. World Health Organization Poverty and TB Vulnerability to severe disease and death from TB Delaying access to care Inhibiting treatment adherence Overcrowding associated with infection and outbreaks of TB TB burden higher where poverty is higher

10. World Health Organization S(+) TB notification rates versus income in Vietnam provinces Source: Ministry of Health of Vietnam, 2003

11. World Health Organization TB notification rates and ethnic groups in Vietnam provinces Source: Ministry of Health of Vietnam, 2003

12. World Health Organization TB notification rates and poverty in Cambodian provinces Source: Ministry of Health of Cambodia, 2002

13. World Health Organization TB notification and poverty TB notification is lower where poverty is higher in Vietnam TB notification is at a similar level between poorer and less poor areas in Cambodia

14. World Health Organization Poverty and TB Case Detection Rate Poor compared to non-poor communities: Higher TB prevalence Lower or similar case notification rates  Lower TB Case Detection Rate in poorer areas

15. World Health Organization Expansion may not be enough ‘The Missing Cases’ Detection Coverage

16. World Health Organization Progress in 2004 Objective 1: Reaching the 70/85/100 targets Targets200220032004* DOTS Coverage (target: 100%) 77%90%94% Case Detection (target: 70%) 40%52%63% Cure Rate (target: 85%) >85% *2004 figures are for high burden countries which account for 90% of the TB burden

17. World Health Organization Impact of scenarios D 70 and D increased on prevalence Decline in prevalence 0 50 100 150 200 250 300 1990199520002005201020152020 rate per 100,000 D70 Dincreased

18. World Health Organization Impact of scenarios D 70 and D increased on mortality

19. World Health Organization Thank you!