Akron Beacon Journal (Ohio)
27 March 2003

HEADLINE: DOTS for TB; A treatment to match a killer infection

Ten years ago, the World Health Organization declared the prevalence of tuberculosis a global emergency. If the anniversary on Monday, which was World TB Day, barely made a ripple, it is understandable. The battle against tuberculosis does not have the drama of the noisier and more explosive war on television.

Yet the effort to control TB may present the stiffer challenge. An infectious disease that destroys the lungs, TB is not a newly discovered affliction, like HIV/AIDS. It is curable and was in decline for years as medical treatments and general health conditions improved in many countries. Still, in 2001, the United Nations' Global Fund to address and control epidemics that threaten the majority of the world's population listed TB along with malaria and HIV/AIDS.

The resurgence of TB, and in some cases virulent forms resistant to most of the commonly used drugs, represents one of the failures of attention. The WHO estimates that the disease kills 2 million people a year worldwide. Tuberculosis ranks as the leading killer of people with HIV/AIDS. In the former Soviet Union and in Africa, the disease is spreading at alarming rates. Fifteen million Americans are infected with the TB bacillus.

The international goal is to detect 70 percent of TB cases and to cure 85 percent of the detected infections by 2005. With those targets, it is hoped, the prevalence of and deaths from the disease could be reduced by half by 2010.

The sad part of the TB story is that for all that is known about the disease and treatment, tuberculosis remains a major health threat to millions, in particular in areas of the world where the continued spread of HIV/AIDS infections threatens human and economic development.

The shame of the TB story today is that an effective and affordable course of treatment is available that, with adequate funding, can halt the spread of the disease.

The WHO indicates that the treatment course, ''directly observed treatment short-course,'' or DOTS has shown dramatic successes in China, India and many other developing countries that have adopted it. The cost of the treatment is estimated at about $10 for six months of drugs. Yet, only a third of people with TB infections receive the DOTS treatment.

A concerted effort, similar to the effort that has cut the costs and made HIV/AIDS treatment accessible, is needed to ensure that TB patients in even the poorest countries receive appropriate health care.