A tale of two global emergencies: Tuberculosis control efforts can learn from the Ebola outbreak

Abstract

In 1993, the World Health Organization (WHO) issued a press release announcing that tuberculosis (TB) was a global emergency, making it the first infectious disease to be declared as such. Although progress has been made, no country has eliminated TB and there are 3 million missed TB diagnoses each year [1]. The term global health emergency has since evolved and most recently, the term & Public Health Emergency of International Concern& (as defined by the International Health Regulations in 2005) was applied to the Ebola epidemic in West Africa, which has caused over 11000 deaths [2]. Ebola control efforts are now focussed on getting to zero cases. Yet, while huge public interest has focussed on Ebola, TB is bereft of public attention despite causing 1.5 million deaths since the Ebola epidemic began a year ago. The WHO End TB strategy boldly aims to end the global TB epidemic by 2035 and envisions zero deaths, disease and suffering [3]. TB elimination is not a new concept but national preparedness plans are currently inadequate [4]. Although the epidemic trajectory of an emerging disease such as Ebola differs from that of a chronic pandemic such as TB, the implications of delayed recognition, poor infection control and pressing diagnostic and therapeutic challenges provide many parallels between the two infections. Thus, TB control efforts could learn valuable lessons from the recent experiences gained during response to the Ebola outbreak.