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article imageDrug-resistant tuberculosis is a 'time bomb' warns WHO

By Adriana Stuijt     Apr 4, 2009 in Health
International health officials gathered in Beijing this week to warn against the deadly drug-resistant strains of tuberculosis.It's a time-bomb, warned the World Health Organisation: spreading fastest in developing countries.
The Bill & Melinda Gates Foundation has already provided a $33-million grant to help China cope with the growing threat of multiple-drug resistant tuberculosis.
And after the meeting in Beijing, the member states of WHO issued a call for worldwide action, noting 'with grave concern' that multiple- and extremely-drug-resistant Tuberculosis is posing a threat to global public health security.
At the moment, a mere 3 percent of all the new multiple-drug-resistant TB cases are being treated according to WHO standards, their statement has warned.
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This is the true alarm bell...
And ominously, some half of all the new cases of tuberculosis that are resistant to multiple drugs are resistant right from the start -- not because of substandard treatment, the head of the World Health Organisation (WHO) warned.
"This is the true alarm bell. This tells us that resistant strains are now circulating in the general population, spreading widely and largely silently in a growing pool of latent infection," director-general Margaret Chan said.
"Obviously this is a situation set to spiral out of control," said Mario Raviglione of WHO.
"Call it what you want, a time bomb or a powder keg, any way you look at it this is a potentially explosive situation."
According to WHO, of the nine million new TB cases annually, about 490,000 are multiple-drug resistant TB (MDR-TB) and about 40,000 are extensively drug resistant (XDR-TB) based on 2006 data.
People with XDR-TB, which has cropped up in 55 countries, have few treatment options and death rates are high. In South Africa it has already led to a socio-economic crisis, in which the laws have to be rewritten to allow some 3,4-million AIDS-TB orphans access to the social-welfare system and free government housing. see
The spread of those strains could compromise the global fight against tuberculosis, which relies on drugs developed decades ago, WHO warns.
China announced steps to provide health coverage for people suffering from drug-resistant tuberculosis, helping to close a gap that has allowed the more deadly strain of the disease to take hold.
China's measures, funded by a $33 million grant from the Bill & Melinda Gates Foundation, include more affordable treatment at hospitals, quicker tests for the strains of tuberculosis that are resistant to standard treatment, and follow-up for patients to make sure they take their medicine.
China ranks second among countries with high rates of MDR-TB, just after India and South Africa. If not cured, patients can infect 10 to 15 people a year, according to the WHO.
Health officials from 27 countries with high MDR-TB rates gathered in Beijing to work out new strategies. Their nations account for about 85 percent of all cases.
Many people aren't being detected, and fewer than 3 percent world-wide are being treated according to WHO recommendations.
Experts fear the rise of drug resistant strains will complicate the fight against the ancient, contagious lung disease, since the drugs needed to fight the tougher strains are far more expensive and unpleasant.
"China provides free treatment to tuberculosis patients, but to date there has not been free treatment for Chinese patients with multiple drug resistance," said Chu Naihui, a senior doctor at the Beijing Chest Hospital. "This meeting, and the big infusion of funding, is good news for tuberculosis patients and especially for MDR patients."
A two-year round of treatment for MDR-TB could cost about 10,000 yuan, or well over a year's salary for the China's urban poor, who are more vulnerable to tuberculosis.
The side effects and the hassle of taking fifteen to twenty pills a day for six months meant many patients stopped taking medicines as soon as they felt better, contributing to the development of drug resistance.
"Especially in the third world, it is extremely difficult to keep patients on therapy for such a long time," said Mel Spigelman, head of the TB Alliance, which is partnering with the Chinese Academy of Sciences to develop newer, faster drugs from natural sources, including traditional Chinese medicines.
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