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WHO: Alarming Increase in Multi-Drug Resistant TB

FILE - A inmate sits in the multi-drug resistant tuberculosis [MDR-TB] ward in a prison hospital in the Siberian city of Tomsk, about 3,500 kilometers east of Moscow, Russia.

The World Health Organization (WHO) is calling for urgent action to stop the spread of multi-drug resistant tuberculosis or MDR-TB. While the agency’s Global Tuberculosis Report 2014 finds a steady decline in the number of TB cases globally, it warns MDR-TB is increasing at an alarming rate.

New estimates show 9 million people developed tuberculosis last year, and 1.5 million died, including 360,000 people who were HIV positive. These figures are terrible, especially since TB is a preventable and curable disease.

The World Health Organization says people should not lose heart, though, as important inroads are being made to get on top of this deadly disease. The report says mortality rates have fallen by 45 percent since 1990 and the number of new cases is declining by an average of 1.5 percent a year.

More complicated treatment

The director of WHOs Global TB Program, Mario Raviglione, said an estimated 37 million lives have been saved through effective diagnosis and treatment of TB since 2000. Unfortunately, he said this good news has to be balanced with the bad news that the global multi-drug resistant crisis continues and is getting worse.

“There are now around 480,000 MDR-TB cases estimated to have occurred in 2013. And as you know, MDR-TB is a form of tuberculosis that is resistant to at least the first two key drugs against tuberculosis," said Raviglione. "When you have this situation, then the treatment changes. It becomes much more complicated, much longer, two years rather than six months, much more expensive, much more difficult to follow and much richer, if you like, of side-effects.”

The WHO report notes MDR-TB constitutes about 3.5 percent of all people who developed Tuberculoses in 2013. It says Central Asia and former Soviet Union countries are the hardest hit regions. It says some countries, notably Belarus and Moldova, are reporting up to 35 percent of new cases of MDR-TB.

Furthermore, it says extensively drug-resistant TB, which is even costlier and harder to treat than MDR-TB, is reported in 100 countries.

Regional resistance

Raviglione told VOA there is no crisis of multi-drug resistant tuberculosis in Africa.

“In terms of MDR-TB, the situation in Africa is probably one of the best in the world. And, this is probably due to the fact they have not used so far an enormous amount of second-line drugs, which, for instance is not the case in the former Soviet Union where there was access to these drugs," he said.

"So, that is how you develop resistance. You expose the patient to a drug without having the proper regimen and you develop resistance to that drug. And, to the fact that national programs in Africa have always worked in a very reasonable way-adopting the standards that have been promoted by WHO for many years,” said Raviglione.

Raviglione cautioned there are signs of MDR-TB growing in some parts of Africa, however, especially in the southern cone. For instance, he noted evidence in Botswana of an explosive co-epidemic of HIV linked with multi-drug resistant TB.

He said these levels have gone up quite quickly in the past few years. He warns that Africa could face huge problems in the future if the two epidemics of HIV and multi-drug resistant TB join forces, as happened with normal tuberculosis.

WHO reports more than 1 million of the 9 million new cases of TB in 2013 were among HIV-positive people, with four out of five cases and deaths occurring in the African region.