In this Lancet opinion piece, Madhukar Pai, a professor and tuberculosis (TB) researcher at McGill University and consultant to the Bill & Melinda Gates Foundation, discusses TB control in India. He writes, “Much has been said and written in the media about totally drug-resistant tuberculosis â€¦ However, all of these discussions really miss the key point — that tuberculosis continues to be a huge problem in India, and that the conditions for emergence of drug resistance are undeniably prevalent, in both public and private sectors.”
Inadequate Government TB Program, Lax Drug Sale Regulations Contributing To MDR-TB Cases In India, Health Groups Say
“India’s inadequate government-run tuberculosis [TB] treatment programs and a lack of regulation of the sale of drugs that fight the disease are responsible for the [increasing] number of drug-resistant cases that are difficult to treat,” health advocacy organizations said in India last week, the Associated Press/Huffington Post reports. “India adds an estimated 99,000 cases of drug-resistant TB every year, but only a tiny fraction of those infected receive the proper” six- to nine-month antibiotic regimen, according to the AP. In India, government-run TB treatment programs only provide drugs to patients on alternate days, increasing the likelihood of missed doses, and patients increasingly are turning to private physicians who are unaware of how to treat the disease, Medecins Sans Frontieres in India and other health groups said, the news agency reports. “The Indian government had no response Friday to requests for comment on the activists’ allegations,” the AP writes (Naqvi, 3/23).
“About 900,000 cases of active tuberculosis (TB) were discovered and treated [in China] in 2011, including 423,000 infectious cases, the Ministry of Health (MOH) announced Monday at a press conference,” Xinhua reports. “Xiao Donglou, a health inspector from the MOH, said at the press conference that China improved its ability to prevent and control TB last year, focusing on HIV/TB co-infections and cases of TB among the country’s migrant population,” noting “1,701 HIV/TB co-infections were reported last year, as well as 51,682 cases of TB among the migrant population,” the news agency writes.
“[O]ften seen in the wealthy West as a disease of bygone eras,” Reuters examines rising rates of tuberculosis (TB) — drug-resistant TB in particular — among the world’s rich and poor. “[R]apidly rising rates of drug-resistant TB in some of the wealthiest cities in the world, as well as across Africa and Asia, are again making history,” Reuters writes. According to the news service, “London has been dubbed the ‘tuberculosis capital of Europe,’ and a startling recent study documenting new cases of so-called ‘totally drug-resistant’ TB in India suggests the modern-day tale of this disease could get a lot worse.”
As more bacteria become resistant to antibiotics, “common infections could become deadly, according to” WHO Director-General Margaret Chan, who spoke on Wednesday at a conference titled “Combating Antimicrobial Resistance: Time for Action” in Copenhagen, ABC News reports. “‘Some experts say we are moving back to the pre-antibiotic era. No. This will be a post-antibiotic era. In terms of new replacement antibiotics, the pipeline is virtually dry,’ said Chan. ‘A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill,'” the news service notes (Moisse, 3/16).
“The Kenyan government’s recent failure to adequately treat a patient with extensively drug-resistant tuberculosis (XDR-TB) has some civil society organizations questioning whether the country’s TB program is equipped to diagnose and treat such patients,” PlusNews reports. “The government admits the TB program in Kenya has not been adequately funded despite the country’s big TB burden,” PlusNews writes, adding, “Kenya ranks 13th on the list of 22 high-burden TB countries in the world and has the fifth-highest burden in Africa.”
In an interview with Xinhua on Tuesday, Francis Adatu, head of the national leprosy and tuberculosis (TB) program in Uganda, warned that TB “remains a major public health problem” and that multidrug-resistant TB (MDR-TB) has emerged in the country, the news service writes. “‘According to our prevalence survey we found MDR-TB in 1.3 percent among new cases and 12.3 percent among people who have been exposed to drugs or treated over and over again,’ Adatu said,” Xinhua writes, noting that Adatu said treatment for MDR-TB was much more expensive than for drug-susceptible TB.
Approximately 85,000 HIV-positive people in Burma, also known as Myanmar, are in need of antiretroviral treatment (ART) and cannot access it “due to a lack of funding, despite renewed international engagement with the government amid a wave of political reform, according to a report released Wednesday” by the medical aid group Medecins Sans Frontieres (MSF), the Associated Press/CBS News reports (2/22). “At the launch of a new report called ‘Lives in the Balance,’ MSF said that only a quarter of the estimated 120,000 people living with HIV and AIDS were receiving treatment, and that it was turning people away from its clinics,” BBC News writes. While plans were made last year among MSF and its partners to scale up treatment for HIV and tuberculosis (TB), “those proposals were shelved after the Global Fund” to Fight AIDS, Tuberculosis and Malaria cancelled its Round 11 grants, according to the news agency. “The money was expected to provide HIV drugs for 46,500 people in Myanmar, along with treatment for another 10,000 people sicken[ed] by drug-resistant tuberculosis in the country, [the report] said,” BBC writes (Fisher, 2/22).
“[T]he highest levels ever of drug-resistant tuberculosis (TB) have been found in Russia and Moldova,” the WHO reports in research published in the February edition of the WHO Bulletin, but “the agency didn’t have data from most of Africa and India, where tuberculosis rates are much higher,” the Associated Press/USA Today’s “Your Life” reports. According to the AP, the “experts reported that about 29 percent of new TB patients in parts of Russia were drug-resistant” and that “65 percent of previously treated patients in Moldova had resistance problems.” The news service notes, “Normally, less than five percent of TB cases are drug-resistant” (2/2).
This post in the Center for Strategic and International Studies’ “Smart Global Health” blog examines drug-resistant tuberculosis (TB), stating, “[S]ince the recent outbreak of the so-called totally drug-resistant tuberculosis (TDR-TB) in India, TB has a new face.” The blog details what TDR-TB is, recaps how resistant strains of TB develop and suggests several ways in which the global health community should respond (Kramer, 1/25).