New Delhi: Causing a death every minute, tuberculosis (TB) remains one of the biggest threats to public health in the WHO-South-East Asia Region. Although the total number of people with the disease has steadily declined in the past decade there are five million people with TB in the Region – a third of the global burden – and more than 3 million are added every year.
On World Tuberculosis Day, 24 March 2011, the World Health Organization emphasizes the need for greater innovation for strategy, diagnostics and new drugs, and universal access to health services, in order to successfully fight tuberculosis. With resistance to current drugs a persistent threat, new, effective drugs for tuberculosis are urgently needed.
“There have been significant achievements in the past decade. However, globally we have a limited number of options to seriously tackle tuberculosis. Our best available strategy, and one that must be strengthened further if we are to have a chance of achieving our goals, is basic directly observed treatment, short course (DOTS), “said Dr Samlee Plianbangchang, WHO Regional Director, for South-East Asia. He added, “We need to ensure a regular supply of quality-assured drugs, and effective detection of cases. In SEAR countries, management of drugs has been strengthened.”
Expansion and strengthening of DOTS (Directly Observed Treatment – Short Course, the strategy recommended to detect and cure tuberculosis) in the 11 Member states of the Region has resulted in over two million people with TB being successfully treated every year. As a result, the proportion of the Region’s population becoming affected with TB has been declining each year and is now a quarter less than 1990 levels, while the number of deaths has reduced by 44%.
Good performance in DOTS in the Region has also led to low proportions of multi-drug resistance among newly detected cases of TB. However, given the large number of TB cases in the Region, this translates to 130 000 people with multi-drug resistant or MDR-TB, accounting for a third of all the world’s MDR-TB cases. Costs of treating MDR-TB are high – nearly 100 times a normal case of TB, requiring high resource inputs and mobilization by the governments, which would mean approximately US$ 400 million each year for emerging cases in the Region. However, provision of quality DOTS services to all TB patients prevents emergence of resistance.
Healthcare services in TB have been expanded to include providers outside the purview of the Ministry of Health, such as railways, military and prison health services as well as private providers. Approximately 30 000 such institutions across the Region, such as medical colleges, private practitioners, large public and private hospitals, corporate institutions, nongovernmental organizations, faith-based organizations and prisons are now working with national TB programmes. In addition, an increasing number of private laboratories are now included in national diagnostic networks.
Business alliances in the Region such as the Thai Business Coalition, the Bangladesh Garments Manufacturers and Exporters Associations and the India Business Alliance to Stop TB, are emerging as players from the non-health private sector by introducing TB services into their workplaces. All of these initiatives have contributed to the improved detection and treatment of tuberculosis in the Region.