The fight against the worldwide tuberculosis epidemic slightly slowed in 2006, the most recent year for which data were available, the World Health Organization warned Monday.

The Global Tuberculosis Control 2008, released yesterday, found that from 2005 to 2006, the rate of increase in detecting new cases of TB fell to 3 percent from an average of 6 percent in the preceding five years (2001-2005). The report was released in advance of World Tuberculosis Day, next Monday.

“After some years of good trends for tuberculosis control, 2006 documents a slowing of progress – the rate at which new cases were detected increased only slightly compared to recent years. This slowdown in progress comes at a time when numbers are still way to high,” WHO director-general Margaret Chan told journalists, according to AFP.

There were an estimated 9.2 million new tuberculosis cases and 1.5 million deaths in 2006, the WHO said in its report, which was based on government data from 202 countries and regions. Of these, 700,000 cases and 200, 000 deaths were among people infected with HIV, the virus that causes AIDS.

The WHO estimates that, including non-detected cases, there were 14.4 million cases of the disease worldwide in 2006.

The African, Southeast Asian and Western Pacific regions accounted for 83 percent of total cases reported. India, China, Indonesia, South Africa and Nigeria rank as the top five countries in terms of absolute numbers of tuberculosis cases. The African region has the highest incidence rate per capita, 363 per 100,000.

According to the WHO officials, some national programs that were making rapid strides during the previous five years have been unable to continue at the same pace in 2006 and this seems to be the major reason for the new worrisome data.

“We’ve entered a new era. To make progress, firstly public programs must be further strengthened. Secondly, we need to fully tap the potential of other service providers. Enlisting these other providers, working in partnership with national programs, will markedly increase diagnosis and treatment for people in need,” Chan said.

The WHO report also names two aspects of the epidemic that could further slow progress on TB.

The first is multidrug-resistant tuberculosis (MDR-TB), reported by WHO last month to have reached the highest levels ever recorded. The bacterial infection becomes resistant when patients don’t complete a full treatment of medication. Drug-resistant TB, like the regular form, can be transmitted through the air to a non-infected person. Only 10 percent of people with MDR-TB will get treatment worldwide in 2008 due to limited laboratory and treatment capacity. Nearly a half million new cases of multi-drug resistant tuberculosis occur each year worldwide, or around five percent of the nine million new cases in total, the WHO said.

A second reason that can contribute to the slow progress on TB is the lethal combination of TB and HIV, which is fuelling the TB epidemic in many parts of the world, especially Africa. Rwanda, Malawi and Kenya were the three African countries achieving the highest HIV testing rates in TB care settings in 2006 with 76 percent, 64 percent and 60 percent respectively.

“The report tells us that we are far from providing universal access to high-quality prevention, diagnostic, treatment and care services for HIV and TB. Clear progress has been made but we must all do more to make a joint approach to reducing TB deaths among people with HIV a reality,” said Dr Peter Piot, Executive Director of UNAIDS, the Joint United Nations Program on HIV/AIDS.

The shortage in funding is another factor that could slow progress on TB. Although there has been an increase in resources, TB budgets are not expected to rise this year in nearly all of the most heavily affected countries, says WHO. 

The WHO officials said the new statistics are worrisome because “the more cases that are detected early interrupt transmission and provide a better chance of cure, and that ultimately has a greater impact on the incidence of the disease,” Dr. Mario C. Raviglione, the agency’s director of tuberculosis control, said in an interview, according to the New York Times.