MIN/Sp/AU/CAMH3/6 TB Page 27 At 46%, new smear positive case detection rate for the African Region is still significantly below the 70% target set by the WHA, MDGs and the AU Heads of state and Government Call for Universal Access. While increasing overtime during the past five years, the region is only achieving 65% of the target. However, based on the WHO TB Global Report 2008, as of end 2006, 10 countries 39 had met the World Health Assembly target of 70% case-detection rate, and 8 countries 40 had achieved the 85% treatment-success rate. Only 2 countries (Algeria and Benin) had met both targets (Table 4.2.3). Treatment Success Rates The level of cured patients and the treatment success rate measure the effectiveness of a programme to reduce sources of infection in a community. This measure is directly affected by the proportion of patients that fail on treatment (Treatment Failures), default from treatment (Treatment Defaulters) are transferred out to other registration units (Transfer out) or die from any cause while on TB treatment. At 76%, the treatment success rate for the 2005 new smear positive patient cohort represents only 89% of WHA, MDG, Stop TB Partnership and African Union Universal Access targets. Only eight countries from the Region 41 have reached the treatment success target. This compares to two countries in 2001, three countries in 2002, four countries in 2003, and eight countries in 2004. A further four countries 42 have attained treatment success rate of 80% and above but below 85%. However, treatment success rates have been increasing progressively since 1999. 5.2.3: Drug Resistant TB Drug resistant TB is essentially a man made problem arising from causes related to the practice of health care workers or the patient. In the former, inadequate dosage, improper drug combinations, or incorrect duration of treatment are the main causes. In the latter, patient intolerance to some drugs, failures to adhere to treatment or defaulting are the commonest causes. Available data shoes that drug resistant TB has emerged as a silent element of the TB epidemic in the region. Regular case notification initiated in 2007 yielded 8,624 MDR-TB cases from 28 countries and 541 XDR-TB cases from four countries. 39 Algeria, Angola, Benin, Botswana, Cameroon, Kenya, Lesotho, Madagascar, Namibia, and South Africa 40 Algeria, Benin, Comoros, DR Congo, Eritrea, Gambia, Mauritius and Sierra Leone 41 Algeria, Benin, Democratic Republic of Congo, Eritrea, Gambia, Mauritius and Sierra Leone 42 Kenya, Rwanda, United Republic of Tanzania and Zambia