Extensively Drug-Resistant Tuberculosis on the Rise; New Reports Say Public Involvement is Critical in Fight
PARIS—Massive social mobilization is needed to defeat the deadly resurgence of tuberculosis, says the Open Society Institute’s Public Health Watch in five new reports released today. The studies on TB policy in Bangladesh, Brazil, Nigeria, Tanzania, and Thailand highlight how TB, HIV/AIDS, and poverty combine to cause almost two million preventable deaths each year.
“The emergence of extensively drug-resistant TB sounds the alarm that the world is facing an urgent health crisis,” said OSI Chairman George Soros, in Paris to launch the reports at the World Conference on Lung Health.
“People and communities have the right to demand more effective action from their governments and from global leaders,” he added.
According to the reports, entitled Civil Society Perspectives on TB Policy, virulent strains of extensively drug-resistant TB (XDR-TB) are now spreading worldwide, posing an especially mortal danger to those living with HIV. The studies emphasize the importance of public engagement in responding to rising TB rates. The disease has put additional strain on health care systems already strapped by the impact of HIV/AIDS, but governments have been slow to increase budgets and personnel.
“TB control efforts must involve both policymakers and the public,” said Afsan Chowdhury, the Public Health Watch researcher of the Bangladesh study.
In many countries, the HIV/AIDS epidemic has fueled a dramatic resurgence of TB. TB is also a leading cause of death for people with HIV/AIDS, although most TB cases can be cured with six months of standard treatment. TB/HIV coinfection and drug resistance complicate and may lengthen diagnosis and treatment.
“In Brazil, only someone with good connections and access to top-quality medical assistance can survive a complex TB/HIV coinfection,” said Brazilian researcher Ezio Távora dos Santos Filho, who is living with HIV and has survived TB twice.
There is little understanding of how TB is spread and that it can be cured, the reports say. Due to stigma, lack of information, and the prohibitive cost of accessing care, many patients do not seek out or fail to complete TB treatment, despite the risk of developing drug-resistant TB that threatens to transform a curable disease into an untreatable plague.
“There is an unhealthy silence around TB,” said Olayide Akanni, the Public Health Watch researcher from Nigeria. “People know the signs and symptoms of HIV/AIDS, but that’s not the case with TB, even though it’s a major killer.”
In Tanzania, there is a direct link between inadequate access to information about TB/HIV coinfection and the stigma attached to TB. Public Health Watch found that women also suffer disproportionately, often having to choose between buying food for their families and traveling to a clinic for medication
“There is very limited information about TB—almost nothing—especially at the community level,” said Public Health Watch researcher Jamillah Mwanjisi of Tanzania. “People automatically think that if you have TB you also have HIV.”
All five reports reveal that poor communities face heightened vulnerability to TB because of the hidden costs in accessing care.
“While TB treatment is free, travel to medical facilities, time off work, purchase of food during hospital visits, and diagnostic services add costs that may limit access for the poor,” Thai researcher Amara Soonthorndhada said.
The World Conference on Lung Health has been an important gathering for medical professionals for decades, but UN Special Envoy to Stop TB Jorge Sampaio emphasized the report’s findings that the battle against TB cannot be won by health care workers and doctors alone.
“In 2005, more people died of TB—a curable disease—than in any other year in history,” Sampaio said. “This is simply unacceptable.”
Biographies of the reports' researchers, a TB fact sheet for the media, and a French-language version of this press release are available for download.
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