Schlüsselwörter
(Deutsch)
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IUATLD - International Union Against Tuberculosis and Lung Disease
Forschung
Gesundheitswesen
Beziehungen
Ausland
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Kurzbeschreibung
(Englisch)
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Tuberculosis is a disease of poverty. Currently, 1/3 of the world's population is infected with the tuberculosis bacillus of whom 8 million people will develop the disease and 2 million will die of it each year. In developing countries, where 95% of cases and 98% of Tuberculosis (TB) deaths occur, the disease is responsible for some 25% of the preventable disease burden. It has also to be kept in mind that TB and HIV are inextricably linked. 70% of the world's 14 million people who are co-infected with HIV and TB live in Africa.
The Association (legal status: International NGO) is based in Paris and was officially founded in 1956. Its denomination was changed in 1989 to become the International Union Against Tuberculosis and Lung Disease (IUATLD). IUATLD is a membership organisation with members from all regions of the world. Switzerland is a member through the "Schweizerische Lungenliga".
IUATLD's aim is the prevention and control of tuberculosis and lung disease as well as related health problems on a world wide basis, with a particular emphasis on low income countries. The way to reach this aim is through promoting national autonomy within the framework of the priorities of each country by developing, implementing and assessing anti-tuberculosis and respiratory health programmes. Recently, the Union has put an additional focus on the interaction between HIV/AIDS and TB. It is IUATLD's policy to only work in a country with the agreement of the government authorities, ensuring that all activities fit into the plans of the respective countries and contribute to a sustainable development of programmes and services.
In the late 1980's, the IUATLD has developed today's' modern TB treatment approach known as Direct Observed Treatment, Short course (DOTS), which later was adopted by WHO. Today, DOTS is still the internationally recognized TB control strategy. Progress in DOTS implementation is remarkable: As of 2002 (latest available figures) 69% of those suffering from clinical manifest TB had access to DOTS. In 1995, the percentage did not even reach 36%. However, full coverage is ultimately needed and answers to new challenges (e.g., HIV/AIDS and TB) have to be elaborated. One of the new worldwide threats is the outbreaks of multi-drug resistant TB (MDR-TB). Especially in parts of Eastern Europe and Central Asia TB patients are ten times more likely to have MDR-TB than those in the rest of the world. On the basis of the DOTS strategy, the so called DOTS-Plus strategy to combat MDR-TB - also elaborated by IUATLD - is currently being tested in numerous countries.
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Projektziele
(Englisch)
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The overall objective of the IUATLD is to improve lung health, particularly in low income countries, through advocacy, health promotion, prevention and intervention to reduce morbidity and mortality from respiratory diseases.
In Annex 2, comprehensive lists of the four main activities of the IUATLD - technical assistance, knowledge exchange, capacity building, advocacy and networking - and the corresponding specific objectives and indicators are presented. The main activities themselves contribute to sustainable health care and services through strengthening of health care systems by working with governments, civil society and non-governmental organisations, empowerment of the population, capacity building and networking.
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Abstract
(Englisch)
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TB was thought to be under control towards the end of last century. However, in 1993 the WHO had to declare TB a global health emergency since the magnitude of the problem changed dramatically during the 1990s due to deteriorating control in some parts of the world (notably Eastern Europe and the former Soviet Union), the spread of HIV, and population growth. Today, the disease threatens one-third of the world's population. Without a coordinated control effort, tuberculosis will infect an estimated 1 billion more people by 2020, killing 70 million.
While anyone can contract TB, the disease thrives on the most vulnerable - the marginalized, discriminated against populations, and people living in poverty - since the transmission happens mainly through proximity and in people with bad health conditions. The lifetime risk to develop clinical disease for those infected with Mycobacterium tuberculosis lies between 5% and 10% in the absence of an effective TB Control programme, but it is much higher in the presence of other risk factors, such as co-infection with HIV. Without appropriate treatment, the case fatality rate reaches up to 50%.
HIV has fundamentally altered the epidemiology of TB. TB becomes reactivated in 5-10% of HIV-infected people per year. While 8% of global TB cases are attributable to HIV, in sub-Saharan Africa the figure is 40%. Annual TB case loads have increased up to seven-fold in the worst HIV-hit countries and current treatment strategies can no longer control the disease.
The global proportion of Multidrug Resistant (MDR)-TB is around 1-2% of all cases, but the problem is greater in MDR 'hot-spots' around the world. The trend in incidence of TB is upwards in sub-Saharan Africa and the Newly Independent States, but elsewhere is generally downwards.
The IUATLD is the leading NGO dealing with TB. Its mission is the prevention and control of tuberculosis and lung disease, as well as related health problems, on a world wide basis and with a particular emphasis on low income countries. It is actively involved in the elaboration of an Information, Education and Communication (IEC) concept to be introduced in high burden countries to increase the awareness among politicians and policy makers and obtain sustained commitment for TB, HIV/AIDS and related conditions. IUATLD provides technical assistance to over 30 countries with the main aim to promote self-reliance in countries, contributing to sustainable health care and services.
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Umsetzung und Anwendungen
(Englisch)
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The IUATLD has been and continues to be the leading agency dealing with one of today's largest public health problems, i.e. with the re-emerging TB epidemic. The probably most important achievement in TB control in the last decades, the development and implementation of DOTS, was the result of the successful work performed by the IUATLD, notably made possible through funding received from SDC and Norway.
Giving the dual challenge of fighting against the devastating effects of HIV and TB for the health status and the economic development in the developing world during the upcoming years, increased efforts will be necessary to support activities in these fields.
In the future, IUATLD might play a key coordination role in the global TB control. This is specially important since many new global initiatives that have been set up in the last few years to address the worldwide burden of tuberculosis (e.g. GFATM, Bill and Melinda Gates Foundation). IUATLD might take a key role in the coordination, provision of critically needed technical assistance and capacity building for putting these funds into action.
Additionally, the rising threat of MDR-TB will have to be answered appropriately asking for a special financial and management effort.
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