According to the World Health Organization (WHO), nearly 1 million people develop tuberculosis (TB) in China each year—more than in any other country except India. In addition to a high burden of the disease, China has about one-fifth of the world’s cases of multidrug-resistant TB (MDR-TB), which is especially difficult and costly to treat.
A decade ago, China expanded the use of the WHO-recommended DOTS TB-control strategy across the country. As a result, 80 percent of TB patients now receive quality treatment in the public health system. This aggressive approach helped China meet its TB-related UN Millennium Development Goal—to reduce TB prevalence and mortality by half between 1990 and 2015—five years ahead of the target date.
In recent years, China has been building the research and manufacturing capacity to help develop new TB-control innovations, including rapid TB diagnostic kits that are more effective and affordable than current tools. Other priorities include new diagnostics and drugs for MDR-TB, which remains a serious problem because the cost of treatment is too high for most patients and many hospitals still provide poor-quality treatment.
Our TB-control investments in China, including a US$33 million grant to the National Health and Family Planning Commission, have focused on developing and demonstrating innovative TB-control models that can help China further reduce the number of patients who develop TB, and particularly MDR-TB.
The model piloted in the first phase of the program, which focused primarily on MDR-TB, identified nine times more MDR-TB cases than the existing system, shortened the time required for diagnosis and treatment initiation by 90 percent, reduced premature discontinuation of treatment by 90 percent, and reduced patients’ share of costs by 80 percent. These results have been praised by WHO as a global model for addressing the threat of MDR-TB.
The second phase of the program, launched in 2013, expands this model into a comprehensive approach for all TB cases that includes integration with health systems, creative financing mechanisms, and the use of new tools such as molecular diagnostics and medication monitors.