Contra Costa Times

March 23, 2001


Spreading the TB cures

THERE IS A DAY to mark TB; World Tuberculosis Day is Saturday. Another kooky publicity stunt, you may wonder. Publicity opportunity, perhaps, but it is not so kooky. TB, once thought to be nearly extinguished, actually kills 2 million people a year. It is the world's leading infectious killer. And instead of the disease coming under control, it is getting worse.

In 1999, 8.4 million new cases of tuberculosis were recorded, 400,000 more than the number of new cases in 1997, according to the World Health Organization. More than one-third of the world's population is infected with the bacillus that can cause tuberculosis. WHO predicts that, should the trend continue, more than 10 million new cases of TB would be registered worldwide by 2005.

TB is a common complication of the AIDS virus, which is at epidemic proportions globally. But TB is also spreading rapidly because strains of the disease are growing drug-resistant and are thus more difficult to treat. But WHO is working to spread the cure. It is planning a facility to help obtain and distribute medicine, plus improve tracking and treatment of tuberculosis. The facility also will help advance the highly effective and cost-efficient treatment program, DOTS (Directly Observed Treatment, Short course).

With DOTS, an observer (almost anyone can be tapped to do it) watches the patient take the daily dosage of medicine and informs the doctor if it's not taken. The strategy has improved cure rates by up to 50 percent and has reduced drug resistance and the six-month course of drugs generally cost less than $15.

The problem, besides patients carelessly self-administering the medicine, is often getting the drugs to the right places, the poor and remote areas of the world. The WHO facility will be a boon in stopping TB's rapid spread. The facility is expected to have the cooperation of various foundations, anti-TB groups and governments, although it is still waiting for the financial commitment of most governments.

As of last week, only Canada had anted up. But several members of the U.S. House of Representatives are proposing that Washington increase its spending on tuberculosis programs worldwide from $60 million this year to $200 million next year, with at least half the money going to the drug facility, the New York Times reported.

The United States should be actively involved in this process although we are not a country of "high burden" when it comes to TB. We must not forget how easily the disease is spread and that it is growing to epidemic proportions.

We can work to stop it now and return it to its nearly eliminated status. We urge financial and moral support for this effort.

© 2001 Contra Costa Newspapers