Since 2013, SJN has partnered with the Institute for Health Metrics and Evaluation (IHME) to share instances of exceptional progress and success in public health (known as “positive deviants”) using research and data produced at IHME. This weekly series highlights a timely example of positive deviance and shows you where has seen the most gains. We don’t, however, always know why such successes took place, which is why we look to journalists like you, in hopes that you’ll use these data as inspiration for stories. Run with the data. Report. Research. Find out how these countries are succeeding–and publish what you find with the world.
Today is World Tuberculosis Day, a time where international organizations turn a spotlight on the burden of tuberculosis (TB) and heightened action against this deadly disease.
Caused by Mycobacterium tuberculosis, TB is an airborne infectious disease that largely affects the lungs but can affect other organs as well. (You can read more about TB from our post last year.) TB claimed about 1.3 million lives in 2013, largely affecting some of the poorest, most marginalized places in the world.
While this kind of death toll remains unacceptably high, the world has made some progress over the last few decades, recording a 28% decline in mortality between 1990 and 2013. And when you account for growing populations, death rates from TB have fallen even faster during this time, a 56% drop in TB deaths per 100,000 people.
Advocates in the fight against TB are calling for faster gains, “to change gear and speed up global efforts” in order to end the disease’s burden on the world. To better understand how to accelerate progress , let’s look at some countries where, historically, TB was a much more lethal killer than it is today.
In absolute terms, Peru and Vietnam saw the largest decreases in TB death rates from 1990 to 2013, falling 79% and 76%, respectively. When you consider which countries had some of the highest TB mortality rates in 1990, Angola and India emerge as leaders, decreasing their very high TB death rates by 59% and 65%, respectively. Smaller countries like Haiti and Nepal, where providing treatment to hard-to-reach populations can be particularly difficult, also recorded substantial gains against TB mortality (declines of 71% and 67%, respectively).
IHME’s Lauren Hashiguchi, who previously worked at Haiti’s largest TB service provider, offers her perspective on why these countries might be experiencing such exceptional progress.
“The biggest challenge in TB control is that many people go undiagnosed or experience long delays before diagnosis,” Hashiguchi notes. “By the time they’re treated, they’re very sick and have exposed others to TB.”
Active case finding is a TB-screening strategy that is increasingly used in low-resource, high-burden countries like Haiti. “This approach has connected people to earlier care and better outcomes,” explains Hashiguchi. “Instead of relying solely on patients to arrive at health facilities when they’re very sick, community health workers go into high-risk communities and screen for TB – and then help patients get into treatment.”
It is with these types of lessons learned, from Haiti or Angola and Peru, that we collectively can help accelerate progress against TB worldwide.