I would like to thank both the International Union against Tuberculosis and Lung Disease and the Anti-TB Association of Thailand for inviting me to address the biggest international meeting on tuberculosis and lung disease to be held in Asia in a decade.

Some of the world's strongest, most positive forces in the battle to stop TB and free the world of tobacco are represented at this meeting today. In the coming days you will hear from them about the great strides that have been made as a result of their efforts.

Leadership by the International Union against Tuberculosis and Lung Disease and the World Health Organization in the last two decades has helped place TB back on the agenda. The Union pioneered the model of TB control now known as DOTS. The Anti-TB Association of Thailand has led the way here in Thailand: three years ago, the Thai government made TB a priority.

But still we have a long way to go. The number of TB cases notified in Eastern Europe has doubled since 1991. There have been increases in Africa, mainly because of HIV. A disease that many of us believed would disappear in our lifetime is killing more people today than at any other time in history. Most of them are young people in the prime of life. Two-thirds of them are here in Asia. Almost all their deaths are preventable.

It is fitting that the 29^th World Conference be held here in Bangkok. Six high burden countries accounting for over 50 percent of the epidemic are here on our doorstep. 4.5 million of the 8 million new cases that occur each year are in India, China, Bangladesh, Pakistan, Indonesia and the Philippines.

Our ability to control the spread of TB pivots on Asia -- now the epicentre of the world's TB emergency. It must be a top priority in our efforts to control the disease. If we cannot control TB in Asia we will never stop TB globally.

Asia is also being devastated by the tobacco epidemic. It is estimated that tobacco will kill some 100 million of the 300 million Chinese men now under 29. Tobacco consumption has risen in Nepal by 241 percent – the highest rate of increase in the world. Women and children in Asia are now proving to be an easy target for the tobacco industry. The region must be a global priority in the fight against tobacco.

At this meeting WHO is releasing its 1998 report on the TB epidemic. It is a sobering report. It describes the grim consequences of inaction in countries not investing in effective TB control. It demonstrates that our greatest challenge today is political. Countries need to invest in effective TB control. The longer they delay in making TB control a priority, the more expensive it will be to fight the disease.

Factors such as HIV, multidrug-resistant TB and the financial crisis converging in this region are increasing the complexity of an epidemic already out of control, making it far more difficult to contain.

HIV is already causing TB to spiral out of control in parts of Africa. By the end of the century, three quarters of a million new TB cases which otherwise would not have occurred will occur globally each year because of HIV.

A decline in the standard of living in the region could increase the spread of communicable diseases like TB. In a climate of changing health sector priorities, there is a danger that some disease programmes lose critical funding.

Surveys in selected sites in Asia showed high levels of multidrug-resistant TB which cannot be treated by the most powerful anti-TB drugs. The situation in areas where emigration is on the rise – not only in Asia but also in Eastern Europe and Russia – are a threat for us all.

Without concerted action focussed on this and other high burden areas, the epidemic will continue to rise, jeopardising global control efforts.

But there is also good news. The pages of the WHO report are also filled with stories of the extraordinary contribution of thousands of people around the world in the fight against TB, demonstrating that one person's dedication can make a difference to the global effort. Today I would like to pay tribute to those people – the health workers, community volunteers and politicians whose actions are saving lives. One million TB patients have been treated with DOTS in the last three years. Over one hundred countries are using the strategy.

We have a choice. We are at a crossroads in TB control. We can allow the global TB epidemic to become more deadly and strengthen its grip on the world. Or we can act now to reduce the suffering and the deaths. But we can and must strike back with the tools that we have.

DOTS is the most effective and affordable strategy available today for detecting and curing infectious TB patients, and cure is the only way to prevent the spread of the infection.

DOTS not only involves direct observation of treatment. It also requires government commitment, microscopy services, reliable drug supply and monitoring of patient progress toward cure. The strategy is integrated into – and strengthens -- general health services to achieve widespread coverage. It needs support from a strong control programme involving all levels of health care.

The powerful anti-TB drugs used in the strategy cost just a fraction of what they did a decade ago – between $10 and $20 per patient for a full course of treatment. DOTS is described by the World Bank and WHO as one of the most cost-effective health strategies. A study suggests that here in Thailand, it could save the country $2.3 billion over 20 years.

Cure rates in half of China using DOTS are as high as 95 percent. It works even in countries that are at war or economically devastated. In some areas where it is introduced, death rates are reduced more than fivefold to less than five percent. Without DOTS, cure rates are lower and drug resistance increases.

Today I invite you to participate in a new Stop TB initiative led by WHO. This initiative is at its very beginning. It is founded on partnership. Only with your and others' participation will we be able to address the real problem of TB in Asia and the rest of the world.

We need to reach out to the TB community but also beyond it – to the UN family, to the private sector and civil society. TB is relevant to organizations that deal with human rights, women's rights, poverty, prisoners and labour markets.

The initiative will develop a global action plan for TB control which identifies the role for different partners. It will focus on a global charter to secure commitments to improve TB control from Heads of State of endemic countries, international organizations, and donors. It will develop mechanisms to ensure global access to quality, fixed dose combination TB drugs.

Urgent action focused on high burden countries, the emerging drug resistance problem and management of TB control in settings of high HIV prevalence is also planned. The initiative will support a balanced agenda for global TB research focusing on short- and long-term results.

By elevating TB control to a political level there is much more that we can do. I urge those who can make a difference to take the right course, support the new initiative and join us to expand DOTS and stop TB.