World TB Day 2023
By Dr. Tefera Azigew | APOPO Head of TB
Each year on March 24th, we celebrate successes in the world of tuberculosis (TB) and take the opportunity to reflect on the commitments, leadership, investments, innovative research, and progress toward ending the TB epidemic. The overall global decline in TB is yet another reminder of this year’s World TB Day theme: “Yes! We can end TB”. However, the pace at which TB is declining is an indicator of the need to accelerate efforts to end TB focused on early detection, treatment, and prevention of TB. The End TB targets set for 2035 are reducing deaths and incidence (new cases) of TB by 95% and 90%, respectively, and milestones are set for 2020 and 2025.
How APOPO Helps
APOPO, a Belgian non-profit organization – with a strong research capacity, has been investigating the use of African giant pouched rats (Cricetomys ansorgei) to screen TB in Tanzania, Mozambique, and Ethiopia since 2007. Aligning with global efforts and the End TB strategy for a world free of TB, at APOPO we strive to contribute using our unique and innovative approach: integrating trained rats to speed up TB diagnosis.
“One TB detection rat can screen 100 samples in under 20 minutes. This could take a lab technician in a partner clinic up to four days. APOPO confirms all rat findings in its lab before notifying the clinics who can then quickly get the patients on treatment.”
APOPO’s Impact
Since its inception, APOPO’s TB detection rats have screened 884,103 sputum samples collected from 523,594 presumptive TB patients and thus helped find 26,378 additional TB patients that were initially missed by routine TB screening in local clinics. According to the World Health Organization (WHO), one person with active pulmonary TB can spread it to up to 15 people a year. Through APOPO’s effort in finding additional TB cases and enabling clinics to link them to treatment, 265,606 potential TB infections were prevented.
In recent years, TB control strategies in Ethiopia and Tanzania have reduced the number of people newly diagnosed with TB and reported, by 5% on average annually (WHO TB report 2022). Ending the TB epidemic by 2035 is possible – Yes, we can End TB! – if TB case notification declines by an annual factor of at least 15% from the current notification (Agizew et al 2022). Therefore, the scale-up of TB diagnostics and active TB case finding on a larger and more sustainable scale is essential.
Milestones to Celebrate
On a very positive note, we are pleased to see that Ethiopia has exited the high multidrug-resistant tuberculosis (MDR-TB) country list. And both Ethiopia and Tanzania have achieved the End TB Strategy milestone of a 20% drop in the number of new TB cases between 2015 and 2020.
Tanzania and Mozambique are among the high TB burden countries to have achieved the End TB Strategy milestone of a 35% reduction in TB deaths between 2015 and 2020. Ethiopia was very close, with a reduction of 34%.
We celebrate APOPO’s contributions to these achievements as we commemorate World TB Day.
What Next?
In addition to APOPO’s ongoing case detection activities, APOPO is hoping to further refine our innovative TB detection research using trained rats – one of the three pillars of the End TB strategy; and to expand our portfolio to detect TB from a range of new sample materials, such as saliva, urine or breath. These sample materials are less invasive and more child-friendly. This research is currently underway in partnership with the University of Manchester and a “human biosensor”, Mrs. Joy Milne.
Just this week, Ethiopia launched a very ambitious strategy called ‘The Multi-Sectorial Response and Accountability Framework to end TB. This strategy aims to reduce the TB incidence from the current 143,000-199,000 to less than 50,000 by 2030 and to less than 13,000 by 2035. It also aims to reduce TB deaths from the current 13,000 to less than 4,000 by 2030 and to less than 1,500 by 2035. APOPO will play a significant role in this endeavor.
The spotlight this World TB Day is to urge countries to ramp up progress in the lead-up to only the second UN High-Level Meeting on TB later this year. This year is critical, with opportunities to raise visibility and political commitment so We can End TB!
You can adopt TB-detection rat Carolina and contribute towards ending TB!
APOPO is deeply grateful for the support and generosity of our partners and donors over the years including the health authorities in the countries it works.
