HEALTH: 10 Million to Benefit from Global TB Drug Facility

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

MEXICO CITY, Mar 22 2001 (IPS) - Close to 10 million tuberculosis (TB) patients in the developing world are set to benefit from a new initiative that seeks to supply free TB drugs over the next five years.

The plan for such an ambitious effort was announced Wednesday in Washington D.C. during the launch of the Global TB Drug Facility, a venture backed by the World Health Organisation (WHO) and the Global Partnership to Stop TB Today.

“Access to treatment and care is basic to human rights,” said Dr. Gro Harlem Brundtland, director-general of the WHO, in a statement to the media released on the eve of the launch. “When access is neglected or denied, health and human rights suffer.”

“We all know that poor people suffer most of the infectious diseases, and TB provides one of the clearest examples,” she added. “It is shameful that many TB patients are still dying of the disease, and inexcusable that less than a quarter have access to TB treatment.”

The WHO is determined to reverse that trend through the Global Drug Facility, which has announced it will include “high quality TB drugs” in its remedy to assist TB patients.

But for that to be achieved, the Geneva-based health body wants the international community to play a significant role, by providing funds for such an effort. At Wednesday’s launch, just days before World TB Day is marked, on Mar. 24, the WHO called for a financial commitment of at least 50 million dollars a year for the next five years to ensure the success of the drive against TB, a disease that kills two million people annually.

The venture did attract financial support from national aid organisations like the Canadian International Development Agency, enabling the Global Drug Facility to move ahead with its plan even before its official launch.

“With an initial contribution from the Canadian International Development Agency, the Global TB Drug Facility recently approved grants to several countries in Africa, Asia and Eastern Europe,” says the WHO.

What is more, confirms this United Nations health agency, this anti-TB initiative may be able to supply drugs to nearly half a million TB patients in its first year of operations based on the initial flow of funds to this programme.

According to the WHO, while the main thrust of this venture will be focused on the developing world, given that it accounts for over 90 percent of the global TB burden, there are indirect benefits that the developed world can gain from such a drive, too.

That stems from the increasing mobility of the world’s population and the manner in which this disease spreads, through the air like a common cold. “There is abundant evidence that national borders are no obstacle to the spread of TB,” reveals the WHO.

Outbreaks of the infection acquired during air travel have become a growing hazard, “and most worryingly, several of these have resulted from Multi Drug Resistant TB (MDR-TB)”, a form of TB that is expensive and difficult to control.

Currently, this disease infects close to three million people annually in South and East Asia, while the annual infection rate in sub-Saharan Africa is over 1.5 million cases and in Eastern Europe, over 250,000 people are infected annually.

According to WHO estimates, however, if TB control measures are not further strengthened, close to one billion people will be newly infected with this disease by 2020, and of that number 200 million will get sick and 35 million will die.

What also adds to the WHO’s urgency to combat this disease is the manner in which the human immunodeficiency virus (HIV) that causes the acquired immune deficiency syndrome (AIDS) has accelerated the spread of TB. “The global TB epidemic increased six percent between 1997 and 1999, largely due to a 20 percent increase in African countries affected by the HIV-AIDS epidemic,” the WHO said.

And such a lethal combination between HIV and TB could result in “some 10.2 million new cases each year by 2005”.

For the WHO, such a chilling prospect is “totally unnecessary” since TB is “the world’s leading curable infectious killer”.

But the available TB control remedy prescribed by the WHO, called DOTS, for Directly Observed Treatment Short-course, has still to make its way into the lives of over 70 percent of those infected.

In a report published this week, the WHO revealed that only 23 percent of people with TB were treated in DOTS programmes.

According to the WHO, such a dismal access record to DOTS, which requires health workers to conduct diagnosis through “sputum smear microscopy” and then prescribe drugs to the TB patients, stems from a range of reasons.

“A significant barrier to rapid DOTS expansion is drug shortages,” despite a six to eight month course of treatment for TB costing about 10 dollars, it notes. “Still shortages are frequent and serious, often caused by financial constraints, inefficient drug procurement systems and poor management.”

For Dr. J.W. Lee, director of the WHO’s Stop TB department, the continuity of such a scenario will only raise questions about the sincerity and commitment displayed in combating this disease.

“Future generations will no doubt ask us why we continued to allow two million people to die every year from a disease that can be cured with drugs that cost only 10-15 dollars,” says Dr. Lee. “They will rightly question our commitment, our priorities, our sense of justice and our understanding of human rights.”

And it is in such a light that this week’s launch of the Global Drug Facility gains importance. According to the WHO, it has been established as the direct result of a meeting in the Netherlands last year attended by government leaders from 20 of the highest TB burden countries.

“They set ambitious objectives to mobilise political commitment and to reach the global targets by 2005, to prevent further spread of TB and multi-drug resistant TB, and called on the international community for assistance,” the WHO said.