Drug resistance threatens India's battle against TB. (March 24th World TB Day)

[Guest guest]

[March 24th. Today is World TB Day. The day marks 125 years since

the cause of TB was first discovered. To reviw the global TB report card vist

the following url.

http://www.healthdev.org/eforums/Editor/assets/publications/PDFs/Global_TB_RC_20\

07_final.pdf Moderator]

___________________________________

Drug resistance threatens India's battle against TB

by Parul Gupta

Drug resistance is emerging as one of the biggest challenges in

India's battle against tuberculosis, the major killer of adults in

the South Asian nation, experts warn.

Three percent of all new TB cases in India and roughly 14 percent of

patients undergoing treatment for the disease have developed

resistance to drugs, studies estimate.

Experts have called for upgraded facilities to better diagnose drug-

resistant strains of TB, a disease which spreads through coughing and

sneezing and usually infects the lungs.

" We have limited facilities for detecting drug-resistant TB in India,

which poses challenges in fighting the disease, " said Nani Nair,

regional advisor on tuberculosis with the World Health Organisation.

" We will have another 24 laboratories to detect the drug-resistant

strain in the next five years, " said Nair, ahead of World TB Day on

Saturday.

In the meantime, just three laboratories, apart from medical colleges

and private hospitals, are equipped to diagnose such strains, she

said.

India reports some 1.8 million new cases every year -- the highest in

the world -- and 1,000 deaths daily despite having one of the world's

most successful anti-TB programmes.

Doctors say mycobacterium tuberculosis, which causes the disease,

develops resistance to all or some of the drugs when patients give up

their treatment mid-way after visible signs of recovery.

" This form of TB is a very big concern for us because it is more

difficult and more expensive to detect and treat, " Nair said.

Even though TB drugs are free in India, many poorer patients abandon

medication because of the difficulty of reporting to the doctor for

supervised treatment at the same time as continuing to work.

Poor nutrition also makes recovery longer and more difficult.

Public health experts said they would use World TB Day to push for

the development of improved drugs and diagnostic techniques. The day

marks 125 years since the cause of TB was first discovered.

" The technique we are using today for primary diagnosis is 125 years

old now. It's a shame we have not made enough investments because

it's a poor man's disease, " said Bobby , who heads advocacy body

Global Health Advocates.

" Multi-drug resistant (MDR) TB is emerging as one of the biggest

challenges in India, but we have not even started reporting it

fully, " said.

Nair said more effective drugs being tested for faster treatment

were " not going to become a reality before another five to 10 years. "

Health experts say India also needs to integrate its facilities for

treating TB and HIV-AIDS.

The weakened immunity of people with HIV makes them most vulnerable

to the disease and India has 5.7 million people living with HIV-AIDS -

- the world's biggest caseload.

" A person with HIV is at considerably higher risk of contracting TB,

but there is not enough cognizance of this problem in India, "

said.

The country has one of the world's largest Directly Observed

Treatment Shortcourse (DOTS) programme -- recommended by the WHO for

TB treatment -- covering its one billion-plus population.

" The programme was reaching less than 200 million people less than

seven years ago. It's the most underplayed public health milestone in

the world, " said.

Under the programme, the country has reached its target treatment

rate of 85 percent. But its detection rate, stands at under 66

percent, behind the target figure of 70 percent.

" The biggest challenge now is to be able to sustain the current

impetus of the marvellous job India has done, " said WHO's Nair.

http://www.france24.com/france24Public/en/administration/afp-

news.html?id=070323034241.csxsqkmi & cat=null