11 May 2006
New Possibilities Emerge for Attacking Tough Tuberculosis
Global research effort proves that poor countries can beat TB
Washington – Multidrug-resistant tuberculosis (MDR-TB) can be treated effectively in poor countries, according to new international findings, providing a new basis for a rapid expansion of TB control programs.
The new findings, issued by the World Health Organization (WHO) May 10, overturn long-standing assumptions that TB strains unresponsive to common drugs are virtually insoluble problems in resource-limited areas. The research opens new possibilities on overcoming an infectious disease that poses an ominous threat to global health.
“What was originally deemed as untenable has become possible,” said Dr. Kenneth G. Castro, director of the Office of Tuberculosis Elimination at the U.S. Centers for Disease Control and Prevention (CDC) and a partner in the research yielding the new findings.
Making that possibility a reality will depend on pouring about $10 billion into the cause over the next decade, Castro said from CDC’s Atlanta headquarters in a Washington File telephone interview. That goal is being pursued by the Stop TB Partnership, a wide-ranging coalition of health and development organizations, public and private, including CDC and WHO.
These conclusions offer new ways to “develop effective and affordable ways to treat MDR-TB patients in poor countries,” said WHO Director-General Dr. Lee Jong-wook in a WHO press release.
About 425,000 cases of TB that do not respond to treatment with commonly used drugs appear each year, and actual global prevalence may be as high as 1 million cases. The reason this difficult-to-treat strain of the lung disease has emerged largely is due to the health system problems common to less-developed nations. Access to medical care and capacity of health systems both are limited, creating difficulties in thorough diagnosis, treatment and follow-up of infected patients.
CDC, WHO and other partners have conducted 46 treatment projects in 29 countries since 2000, Castro said. Working with hosting local organizations, the projects have developed community-based treatment programs that surmount the old problems. “Yes, you can diagnose [TB cases],” Castro said, discussing what the projects have shown. “Yes, you can access drugs that were thought to be prohibitive.”
CDC helped local partners refine TB treatment regimens in Botswana, Brazil, India, Latvia, Peru and Thailand with financial support from the U.S. Agency for International Development.
The Global Plan to Stop TB 2006-2015 targets all strains of TB, a goal that can be achieved with a $56 billion investment, according to estimates. The goal to scale up treatment for patients of MDR-TB calls for a rapid increase from 16,000 patients currently to 800,000.
“Extreme drug resistant TB bugs pose a mortal danger to control in many countries, and treatment programs need to be scaled up as fast as possible to counteract this threat,” said Dr. Mario Raviglione, director of WHO’s Stop TB Department.
MDR-TB is caused by TB bacilli resistant to isoniazid and rifampicin, the two most powerful anti-TB drugs. Rates of MDR-TB are high in some countries, especially in the former Soviet Union, and threaten TB control efforts, according to WHO.
While drug-resistant TB generally is treatable, it is often more than 100 times more expensive than treatment of drug-susceptible TB.
For additional information, see Global Issues.
(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)
