Public Health England (PHE) and NHS England have announced an £11.5 million investment as part of a collaborative initiative to decrease tuberculosis (TB) cases and ultimately eliminate TB as a public health problem in England.
In 2013, there were 7,290 TB cases reported in England, an incidence of 13.5 cases per 100,000 of the population. The UK has the second highest rate of TB among Western European countries and rates are nearly five times higher than in the US.
Jane Ellison, Public Health minister, said: “This strategy is a significant step forward in helping us to control and reduce cases of TB, which still affects thousands of people in England every year.
“It will target those most vulnerable to TB by improving access to screening, diagnostic and treatment services as well as innovative outreach programmes such as the ‘Find & Treat’ mobile health units. Last year I saw the first of these fantastic units at work and am delighted that the team launched their second mobile health unit earlier today.”
Professor Paul Cosford, Director for Health Protection and Medical Director at PHE, added: “TB should be consigned to the past and yet it is occurring in England at higher rates than most of Western Europe. This situation must be reversed.
“While many local areas in England have taken major steps to tackle TB, there is still unacceptable variation in the quality of clinical and public health measures across England.
“Combating TB is a national priority for PHE and today’s announcement will mark the start of our five-year plan to make a real difference.”
PHE and NHS England have worked with key stakeholders to develop this strategy for England.
The 10-point action plan will include improving access and early diagnosis,; better treatment, diagnostic and care services, tackling TB in under-served groups, and improved screening and treatment of new migrants for latent TB infection, in order to bring about a year-on-year reduction in TB cases.
The figures are in marked contrast to the United States, Germany and the Netherlands, which have all seen consistent reductions by using concerted approaches to TB prevention, treatment and control. If current trends continue, England will have more TB cases than the whole of the US within two years. Drug resistant TB is also an increasing problem in England, with cases of multi-drug resistant (MDR) TB increasing from 28 cases reported in 2000 to 68 in 2013.
In England, TB is concentrated in large urban centres, with ‘hot spots’ in London, Leicester, Birmingham, Luton, Manchester and Coventry. TB clinics in London manage more cases a year that those in all other Western European capital cities put together.
Professor Sir Bruce Keogh, NHS England’s Medical Director, said: “This is an important strategy, which is why NHS England is committing £10 million towards tackling the high rates of TB incidence in England. This money will focus on TB screening and any subsequent treatment. Our goal is to eliminate TB as a public health problem.”
The TB strategy was developed by PHE and NHS England following a 3 month consultation which included responses from over 100 different stakeholders. Other key partners actively involved in developing the strategy include the British Thoracic Society, TB Alert, the Local Government Association, the Department of Health, the Association of Directors of Public Health and the National Institute for Health and Care Excellence (NICE). PHE will provide annual reports on progress across a suite of indicators relevant to the key areas of action.