Inadequate attention to tuberculosis giving rise to drug resistant TB

Dec 4, IRNA

Drug-resistant tuberculosis on the rise! Multidrug-resistant tuberculosis (MDR-TB) has been recorded at the highest rates ever, according to a recent World Health Organization (WHO) report.

According to a press release issued by the UN Information Center (UNIC) here on Thursday,the report estimates that worldwide, every year there are 490 000 new patients suffering from MDR-TB and 110 000 deaths. Equally alarming, a new form of virtually incurable drug-resistant tuberculosis, known as extensively drug resistant (XDR) tuberculosis was also reported to be confirmed in 45 countries.
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Although precise data are not available, it is estimated that 40,000 new cases of XDR tuberculosis emerge in the world every year.

The rise in MDR-TB has been attributed to many factors, including incorrect administration of treatment regimens by health care workers, failure to ensure that patients complete the whole course of treatment, limited laboratory capacity for diagnosis and insufficient effort in many parts of the world to treat and control MDR-TB.

Following a meeting in Cairo, on Monday, of the Coordinating Board of the Eastern Mediterranean Partnership to Stop TB, a statement was issued on the tuberculosis situation in the region. The meeting was attended by board members from different countries, officials from WHO and representatives of civil society.

According to the statement, failure to control tuberculosis is helping drug-resistant tuberculosis to rise. Tuberculosis continues to pose a health and development threat to the world in general and to the Eastern Mediterranean Region in particular. At present, although a completely preventable and curable disease, tuberculosis is among the leading causes of adult mortality in low-income and middle-income countries, causing approximately 2 million deaths a year worldwide and 110,000 in the Eastern Mediterranean Region. According to WHO, tuberculosis infection is currently spreading at the rate of one person per second. It kills more young people and adults than any other infectious disease and is the world's biggest killer of women.

Because of the continuous efforts by governments and private sector, supported by WHO and the Stop TB Partnership, significant progress has been made in recent years to control tuberculosis in the Eastern Mediterranean Region. Despite the impressive progress made by some countries towards the Millennium Development Goals (MDGs), the average case detection rate (number of new tuberculosis cases detected) in the region is 53% compared to the target of 70%. Several challenges hinder the progress, including inadequate financing of tuberculosis control programs, weaknesses in health systems, lack of human resource capacity, the high level of stigma attached to tuberculosis and inadequate involvement of the community in tuberculosis care.

The slow progress in tuberculosis control has given rise to the massive challenge posed by drug resistance or MDR/XDR tuberculosis.

WHO estimates that globally nearly half a million cases are resistant to first-line tuberculosis drugs and need immediate attention. In the region, there are no accurate estimates of numbers of patients with MDR/XDR tuberculosis but if the global average is applied, there could be 30,000-40,000 patients with this highly infectious disease.

Treatment is 100 times more expensive than treatment for regular tuberculosis and treatment facilities for drug-resistant tuberculosis are not available in all countries. Inadequate attention to tuberculosis is helping drug-resistant tuberculosis to rise.

Steps being taken: WHO and the Stop TB Partnership (through the Green Light Committee) are assisting countries in establishing drug- resistant tuberculosis care but the scope remains limited and urgent action is needed from governments and civil society. In May 2008, the regional leaders from the community, public and private health sectors, and business took a major step forward when they announced the launch of a partnership - the Eastern Mediterranean Partnership to Stop TB. The Partnership has taken up the cause of working with media to create awareness, to help mobilize financial resources for tuberculosis and drug-resistant tuberculosis and to encourage local community action to help tuberculosis control programs fight the disease.

Based on the recommendations of the Coordinating Board, Professor Tag Eldin and Mr Rahim made an immediate call for action from governments, donor institutions, civil society and media.

For governments: To scale up tuberculosis care by increasing political commitment to tuberculosis control, ensuring sustained financing at country level, building capacity of the national tuberculosis control programs, and immediately initiating or strengthening drug-resistant tuberculosis care.

For Donors: To provide adequate financing support to resource poor countries for tuberculosis control.

For civil society: to promote support for tuberculosis control by creating mass awareness and larger societal commitment to control of tuberculosis and supporting tuberculosis patients and affected families.

For media: To encourage mass awareness among the community, and build pressure on governments to continue commitment to tuberculosis control and establish/strengthen drug-resistant tuberculosis care.