A global strategy to eliminate tuberculosis disease by 2050 will not succeed unless more can be done to prevent infection from progressing to disease, Prof Philip Hill says.
"If we're going to have such bold goals, we might have to match them with bold actions," he said yesterday.
Prof Hill, director of the University of Otago's recently-established Centre for International Health, will discuss Tb control in developing countries in an inaugural professorial lecture in the Colquhoun lecture theatre at Dunedin Hospital at 5.30pm today.
The centre will also be formally opened today by vice-chancellor Prof David Skegg.
Prof Hill said about nine million new cases of tuberculosis occurred throughout the world each year, more than 90% of them in developing countries.
The highest rate of Tb cases was in Africa, which also had the greatest number of Tb deaths.
Tb could be controlled by preventing infection, by preventing progression from infection to disease and by treating active disease.
The current global control strategy did not include preventing infection from progressing to disease through treating with antibiotics the estimated two billion infected people in the world.
Tests to identify the infection had significant limitations, the risk of progression to disease was relatively low, and the overall cost of stopping infection from progressing was very high.
However, recent modelling work suggested that ignoring infection - in the absence of disease - meant that reaching the goal of reducing Tb cases to less than one case per million of the population by 2050 would not be possible.
New "post-exposure" Tb vaccines might be able to prevent progression to disease as their main effect, he said.
• About 5% of people who are infected with Tb develop the disease within a few months, a further 5% develop it later, and about 90% of those infected do not experience the disease throughout their lives.
