Ladies and Gentlemen, 

2005 is a very important year for tuberculosis control. By the end of this year, we should achieve, the global targets for tuberculosis control. The targets are to detect 70% of the existing cases of tuberculosis and to successfully treat 85% of them. Once we achieve the global targets, we should then move towards the Millennium Development Goal relating to tuberculosis. This is to “have halted by 2015 and begun to reverse the incidence of tuberculosis,” as stated in goal 6. 2005 should therefore become a turning point in tuberculosis control: achieving the global targets and moving towards the Millennium Development Goals. 

On the occasion of World Tuberculosis Day, I would like to extend my thanks to those who have worked so hard to improve tuberculosis control in the countries of the Region, and particularly those who take day-to-day care of tuberculosis patients and their families. The provision of comprehensive care for tuberculosis patients based on the WHO recommended tuberculosis control strategy DOTS is dependent on the commitment of these frontline health workers and treatment supporters. Access to DOTS, or directly observed therapy, short course, has been expanded throughout the health services of almost all ministries of health in the Region, except Afghanistan, Pakistan and the southern part of Sudan. Even in these three countries, particularly in Pakistan, DOTS is undergoing rapid expansion. In 2003, a total of 205 980 tuberculosis patients received comprehensive care under DOTS in the Region. This is indeed commendable progress, and it is primarily the frontline health workers that are behind this progress. 

Tuberculosis control is, however, a long-term intervention and we need to continuously improve our activities. The first critical step is to achieve the global targets. In this regard, I have to commend you and warn you at the same time. The target for treatment success, i.e. 85% of cases, is almost achieved, the regional average being already 82%. However, the target for case detection, i.e. 70% of cases, is far from achieved with the regional average standing at only 32%. Low case detection in Afghanistan and Pakistan, which have the highest burden of tuberculosis in the Region, is the main cause for the low case detection rate for the Region as a whole. However, case detection is also low in six other countries, less than 50%. In reality, only eight countries had reached 70% or more for case detection by the end of 2004.

Rapid improvement in case detection and accomplishment of the global targets are urgently needed. This is the only way for us to move towards the Millennium Development Goals and to realize the final objective, which is to eventually decrease the incidence of tuberculosis. There are, however, encouraging examples we can share with you. Morocco and Tunisia achieved the global targets last year, and have shown a declining incidence in tuberculosis. In Jordan and Oman, which expect to achieve the global targets this year, a similar decline in incidence is being seen. These are indeed good signs, like the light at the end of a long tunnel. 

Ladies and Gentlemen,

Tuberculosis control is a long term endeavour. I would like to remind you of the social, economic and moral impact of tuberculosis. Every year, more than 100 000 people are estimated as dying from tuberculosis in the Region. This is not acceptable at all. We have wide DOTS coverage, high treatment success, and evidence that tuberculosis incidence can be reduced. I often wonder why, then, people must suffer and die from this curable and preventable disease. The majority of those who die from tuberculosis are  young adults. This means that tuberculosis is taking the lives of bread-winners, and seriously affecting the social and economic lives of their families. Tuberculosis often forces patients and their families into a vicious cycle of poverty and ill health from which it becomes difficult to escape. This cannot be acceptable.

World Tuberculosis Day is a day on which to raise our voices and take action to stop further sufferings. Tuberculosis is both preventable and curable. We have a proven strategy for provision of the best care to tuberculosis patients, which is the DOTS strategy. We have the workforce to provide that care to those who need it, and that is the teams of health workers at the frontline. We need to raise awareness further, in the media and through the media, among the public at large, of the seriousness of the tuberculosis threat and of how it can be treated.

The regional theme of World Tuberculosis Day 2005 is: “Tuberculosis is curable. We should not let anyone die from tuberculosis.”

With this theme, I would like each one of you to make World Tuberculosis Day  2005 the day to start a year-long campaign. A campaign that will aim at raising awareness about the regional tuberculosis situation, about the availability of the best care, which is DOTS, and about the actions that are needed to stop deaths from tuberculosis. The campaign should be addressed at health decision-makers, through the mass media, and at the community.

I very much look forward to hearing about your one-year campaign activities in the coming year, and to receiving a final activity report on World Tuberculosis Day 24 March 2006.