Brian O'Shea (Waterford, Labour)
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Question 60: To ask the Tánaiste and Minister for Health and Children the steps she intends to take to strengthen tuberculosis control measures in order to meet a World Health Organisation target to eliminate the disease by 2050; the plans she has in place to ensure thorough tracing of patients who have been in contact with a tuberculosis patient to prevent spread of the disease; and if she will make a statement on the matter. [15469/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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In January 2006, the WHO Stop TB Partnership launched the Global Plan to Stop TB 2006-2015. This plan sets out actions towards a world free of tuberculosis. The plan outlines what needs to be done to make an impact on the global burden of TB and to achieve the partnership's goal of reducing TB deaths and disease by 50% by 2015. The WHO goal for 2050 is the elimination of TB as a public health problem.

In Ireland, there has been an overall downward trend in notification of tuberculosis. The combination of better living conditions, antibiotics against TB and the BCG vaccine has dramatically reduced the number of cases of TB in Ireland. In 2003 the total number of cases notified nationally was 407.

The National TB Advisory Committee and the National Immunisation Advisory Committee keep policy under review. The National TB Advisory Committee advises that there are four components to a successful TB control programme: BCG vaccination; early detection; early treatment; and early contact tracing. The committee also recommends that the universal neonatal BCG vaccination programme should be continued in Ireland for the immediate future with the aim of moving later to a selective BCG vaccination programme which targets high risk groups. The National Immunisation Advisory Committee recommends BCG vaccine for all newborn babies. There is currently a national screening programme for TB in respect of asylum seekers, as these individuals may come from countries with a higher incidence of TB.

The International Union against Tuberculosis and Lung Disease has stipulated that a well functioning TB programme is one of the criteria for countries — with low prevalence of TB — to have attained prior to discontinuing a universal neonatal BCG programme. A well functioning TB programme must have the structures and processes in place to ensure early detection of cases, institution of appropriate treatment in a timely manner, early identification of non-compliers and the capacity and facilities to institute supervised therapy where appropriate. In light of this a subgroup of the National TB Advisory Committee has been established to propose a model for ensuring an effective TB control programme in Ireland.

The objectives of contact tracing are to identify contacts who are likely to have been infected recently and may require preventive therapy, to identify contacts with active disease who require curative therapy, and to identify and treat the original source of the infection. Contact tracing of one case may often involve screening of a large number of people, including household, school and workplace contacts. The minimisation of risk to contacts is dependent on close co-operation between clinicians who must notify cases promptly and public health staff who ensure that thorough contact tracing is carried out.