WHO: drive to curb drug-resistant TB; 2 year plan

[Gert van der Hoek]

Drive to curb drug-resistant TB


The World Health Organization has unveiled a two-year plan to combat the spread of drug-resistant tuberculosis.

It is hoped the measures will prevent hundreds of thousands of cases of drug-resistant TB - and save as many as 134,000 lives world-wide.

The aim is to prevent, treat and tightly control cases.

Dr Margaret Chan, WHO director-general, has called drug-resistant TB "a threat to the security and stability of global health."


Extensively drug-resistant TB (XDR-TB), a form virtually immune to antibiotics, has been reported in 37 countries in all regions of the world since emerging in 2006.

It is estimated that there may already be up to 30,000 cases a year.

Some 8.8 million people each year develop normal TB, a bacterial infection that usually attacks the lungs.

In addition, about 450,000 people a year are infected with a multi-resistant form (MDR-TB) which is resistant to the main first-line drugs.

Ambitious plan

The WHO proposals emphasise the need to boost basic TB control and target investment in key areas, such as treatment programmes, diagnostic laboratories, and research into new drugs and vaccines.

Dr Mario Raviglione, director of the WHO Stop TB Department, said: "It is an ambitious plan that must be fully supported if we are to keep a stranglehold on drug-resistant TB."

The plan's coordinator, Dr Paul Nunn, warned that if drug-resistant TB was allowed to spread unchecked, the world could be pushed back to a pre-antibiotic era with no real hope of a cure.

He said: "At the moment we have around nine million new cases of tuberculosis occurring each year, most of which are sensitive to the standard drugs.

"If we allow drug resistance to be created and to expand unchecked then we face the possibility of that epidemic of drug-susceptible TB being replaced by really very drug-resistant TB.

"This pushes us back to the pre-antibiotic era, back into the time of sanatoriums and fresh air and sunlight and no real definite hope of a cure."

Growing threat

Researchers flagged up the growing threat of new strains of highly-resistant TB in March 2006.

Concerns were heightened six months later by a cluster of "virtually untreatable" cases in an area of South Africa with high prevalence of HIV.

All but one of the 53 patients died in an average of 25 days after samples were taken for drug resistance tests.

And last month a US citizen was found to have extensively drug-resistant TB while travelling around Europe on his honeymoon.

The total budget for the two-year plan is US$2.15bn.

Story from BBC NEWS:

http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/6229406.stm

Published: 2007/06/22 08:50:13 GMT

 

[Gert van der Hoek]

Re: WHO: drive to curb drug-resistant TB; 2 year plan

WHO seeks over 2 billion dollars to tackle drug-resistant TB

The World Health Organisation said Friday it is seeking 2.15 billion dollars (1.6 billion euros) in its fight against drug-resistant strains of tuberculosis, amid warnings of a "return to the pre-antibiotic era" if they spread unchecked.

Between 400,000 and 450,000 people worldwide suffer from multi-drug resistant tuberculosis (MDR-TB), and an estimated 25,000-30,000 from the more severe extensively drug-resistant TB (XDR-TB), WHO tuberculosis expert Paul Nunn told journalists in Geneva.

At least 37 countries worldwide have reported at least one case of XDR-TB, he added.

The WHO and Stop TB Partnership's "Global Response Plan" aims to save the lives of 134,000 MDR and XDR-TB patients over the next two years, by working to better diagnose and treat "basic" TB before drug-resistance occurs, and also to develop treatments that are effective against the new strains.

"We're anticipating, if this plan is fully funded, a tenfold increase in the number of cases diagnosed and treated for MDR-TB," by 2007-8 from 2005, Nunn said.

Some two thirds of MDR-TB cases are in China, India and Russia, with China alone accounting for at least 140,000 cases each year, he noted.

So far, only Hong Kong has reported a case of XDR-TB, but Nunn said it would be "rather surprising" if no such cases had occured on the Chinese mainland. The problem is that China does not have sufficient laboratory capacity to detect such cases, he said.

The WHO first became concerned about XDR-TB in March 2006, and a deadly outbreak among HIV patients in South Africa's Kwazulu-Natal province later that year only confirmed their fears, Nunn said.

In a worst case scenario, the 8.8 million annual cases of treatable TB worldwide could be replaced by an equivalent number of XDR-TB cases, he warned, noting that each one case of TB infects between 10 to 15 other people each year.

"The possibility is that you could replace that epidemic with a drug-resistant epidemic, in other words you could have 8.8 million cases of drug-resistant TB wandering around -- and then you will be back to the pre-antibiotic era," Nunn said.

"The paradox is that the frightening XDR-TB is fully preventable by properly diagnosing people and treating them as prescribed with effective drugs," said Leo Reichmann of the Stop TB Partnership.

Nunn echoed this point and stressed the need for a massive increase in laboratory capacity to diagnose and treat patients, particularly in the world's poorest countries.

"There is no way that we can even begin to diagnose and treat the number of patients that need to be diagnosed and treated unless we have a huge scale-up in lab capacity," he said, noting that there are more such laboratories in South Africa alone than in all of sub-Saharan Africa.

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