Africa News
Headline: Only a Fraction of TB Patients Get Adequate Care
Date: March 25, 2002
A strategy that can cure up to 90 percent of all tuberculosis (TB) cases,
and thus represents the best chance for controlling the global TB epidemic, is reaching
only 27 percent of the world's TB patients, the World Health Organisation (WHO) reported
on Friday. The announcement was made by WHO in conjunction with the release of its latest
annual report on TB, entitled "WHO Report 2002: Global Tuberculosis
Control", and World TB Day on 24 March.
Public health officials had estimated that US $1 billion a year would be needed to treat
patients and control the TB epidemic in 22 countries that now accounted for 80 percent of
the world's TB cases, WHO stated. It also noted its surprise in finding that the
governments of these 22 low-income nations were already paying 70 percent of the cost of
TB treatment and control. "Clearly, even the poorest countries are deeply committed
to fighting this disease, and the international community must respond just as
vigorously," J.W. Lee, WHO's Director of Stop TB, said. The strategy developed by WHO
to fight TB, known as "DOTS" (directly observed treatment), has been cited as
"one of the most cost-effective strategies ever devised against a major killer",
according to WHO. DOTS has five key components: government commitment to sustained TB
control; case detection by sputum microscopy; standardised treatment of six to eight
months; regular supply of essential TB drugs; and a standardised reporting system.
It also requires that health workers watch TB patients take their drugs for at least the
first two months of therapy, thereby reducing the chance of patients abandoning treatment
before they are cured - which can lead to drug resistance developing in the patient, and
that same resistance being passed on to others.
By the end of 2000, 148 of 210 countries were implementing the DOTS strategy, an increase
of 21 countries since 1999, according to WHO. Where the DOTS approach was used in Asia,
Africa and Latin America, it had produced an average cure rate of 80 percent, WHO added.
The goals set for TB control are that by 2005, 70 percent of all active infectious TB
cases will be diagnosed and 85 percent will be successfully treated. "This requires a
regular supply of drugs, equipped labs and trained health professionals," WHO stated.
"While all of this is expensive, even the poorest countries are financing the bulk of
TB costs themselves." "Even so, this still leaves a gap of $300 million a year;
about 30 cents a year for each person in the industrialised world," WHO added.
"This shortfall has slowed the rate of expanding diagnosis and treatment
services." According to the new WHO report, at the current rate, TB targets set for
2005 will not be reached until 2013.
TB is a contagious disease that spreads through the air. Nearly one third of the world's
population is infected with the TB bacillus, and 2 million people die of it each year. In
1993, the growing worldwide TB epidemic so alarmed public health experts that WHO declared
TB a global emergency. In Africa, TB is the major cause of death of people with HIV/AIDS.
WHO regularly assesses the state of the epidemic as well as progress being made against
it. The current assessment is the sixth such report. For the complete report, go to: http://www.who.int/gtb/publications/globrep02/index.html
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