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Is Multidrug- Resistant Tuberculosis Rising as New Global Health Crisis?


The medical humanitarian organisation Medcins Sans Frontieres has announced ahead of world TB day on the 24 March that alarming new data suggests the global reach of multidrug-resistant tuberculosis is a lot larger than previously estimated, and is going to require a intensive international effort to combat this deadlier form of the disease.

TB has existed since ancient times; it is spread through the air i.e. coughing, sneezing, it is a common and in many cases lethal disease, particularly in many Asian and African countries due to a more compromised immune system owing to the high rate of Aids. Tubercular decay has been found in the spines of Egyptian mummies and is still the second biggest killer worldwide today.

The global multidrug-resistant Tuberculosis (MDR-TB) emergency coincides with a colossal gap in access to diagnosis and treatment, existing diagnostic tools and medicines are outmoded and extremely expensive, couple these factors with inadequate funding and the disease threatens to spread faster and further.

Worldwide less than 5% of TB patients have access to correct diagnosis of drug resistance and only 10% of MDR-TB patients are estimated to have access to treatment, Medcins Sans Frontier president Dr Unni Karunakara said, “Wherever we look for drug resistant TB we are finding it in alarming numbers, suggesting current statistics may only be scratching the surface of the problem, with 95% of TB patients worldwide lacking access to proper diagnosis, efforts to scale-up detection of MDR-TB are being severely undermined by a retreat in donor funding-precisely when increased funding is needed most.”

World wide data collected by Medcins Sans Frontieres have shocked doctors battling the disease.

Myanmar-an estimated 9,300 new cases of MDR-TB each year so far only 300 patients have received treatment.

Uzbekistan (south central Asia)-65% of patients treated by MSF in 2011 were diagnosed with MDF-TB,30-40% of these had presented to the clinic for the first time, an exceptional number globally, indicating that drug resistance is not only due to incorrect treatment but that it is spreading in its own right.

South Africa has seen a 211% increase in MDR-TB per month.

India-an estimated 99,000 people are infected with MDR-TB each year, only 1% receive tolerable treatment. Over the counter drugs and unregulated private health sector add fuel to the crisis.

This global crisis is exacerbated by a vicious circle of long treatment regimes (two years) using highly toxic drugs most of which were developed mid 1900,” recent Global Fund cuts and a small manufacturing market has kept the costs of some drugs out of reach where needed most, also the use of a new rapid diagnostic tool that has the potential to hugely increase early detection of drug resistant TB in hours rather than weeks cannot be used where necessary due to high costs.

Dr.Karunakara said “we need new drugs, new research, new programs, and a new commitment from international donors and governments to tackle this deadly disease, only then, will more people be tested, treated and cured. The world can no longer sit back and ignore the threat of MDR-TB. We must act now.

MDR-TB: Multidrug-resistant TB (MDR-TB) is a form of Tb that does not respond to standard treatments using first-line drugs. It is difficult and takes much longer to treat-around two years, with highly toxic drugs. Drug-resistant tuberculosis (DR-TB) developed during the treatment of drug sensitive TB, when patients fail to complete their full course of treatment, drug supply interruptions, or when health care workers provide improper drug doses or improper, expired, or poor- quality medicine; and is now transmitting from person to person in its own right.

Funding cuts: Faced with a serious funding shortage after a disappointing replenishment conference and after donors scaled back their pledges, the Global Fund to Fight Aids, Tuberculosis, and Malaria took the unprecedented step in November 2011 of cancelling a round of funding grants. Without “Round 11,” no new grants for scale-up will be disbursed until 2014, leaving countries unable to aggressively tackle their epidemics. The cancelation of Global Fund Round 11 comes at a time when scale-up of DR-TB programs is most needed.

Fiona Hammond is a journalist who graduated from the John Morris journalism academy. Fiona lives on the south coast of NSW Australia and writes human interest stories and opinions, about gardening, sustainability, fishing, the environment and our planet.

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