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WHO: TB Battle in Asia Far From Over - 2004-03-24


On a day marking the discovery of the germ causing tuberculosis - the World Health Organization says efforts have been effective in limiting TB's spread. But drug-resistant strains in China and Eastern Europe mean the battle against the illness is far from being won.

The World Health Organization says tuberculosis, which attacks mainly the lungs, kills about two million people worldwide each year. The U.N. health agency, which released a report marking World Tuberculosis Day on Wednesday, thinks the disease is being controlled - as about three million tuberculosis patients have access to treatment.

However, the health charity Doctors Without Borders singled out China and Pakistan for what it called "a lack of political commitment to fighting tuberculosis" on Wednesday. The agency also reported that India makes up about 30 percent of the world's cases.

Pieter Van Maaren, a WHO health officer based in Manila, says the incidence of the potentially deadly disease varies greatly throughout Asia. In the northeast, he says, China has one the highest incidence but the disease is well controlled in affluent areas.

"Tuberculosis is still very common in China," says Mr. Van Maaren. "If we look at a major city of one million people you would see approximately two to three hundred new infectious TB cases every year." He says that in Southeast Asia and the Pacific, Vietnam, Cambodia, Laos and Papua New Guinea have high incidence.

Dr. Van Maaren says that in China and Southeast Asia, the growing number of HIV and AIDS cases is helping tuberculosis spread. Tuberculosis can be dormant in a person for years but develop when the immune system is weakened or compromised.

Dr. Van Maareen says another concern is the growing prevalence of drug-resistant strains. At the moment, a variety of antibiotics are effective in curing most tuberculosis patients. But if the antibiotics are not taken consistently or doses are incorrect, the germ can change so that medicines become useless.

The spread of drug-resistant strains could result in sicker patients.

Several studies indicate that in China one in 10 TB patients have a drug-resistant strain. The problem, however, is far greater in Eastern Europe where about 30 percent of patients cannot be cured with drugs.

Dr. Van Maareen says that if WHO's guidelines for detection and treatment are followed properly the disease could possibly be eliminated within decades. He estimates that about $800 million is needed annually to effectively fight TB in China and Southeast Asia.