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healthcare in lesotho
Lesotho, a small nation in southern Africa, is continually improving its access to healthcare systems. Still, even with greater access to healthcare services in some of the areas that are more difficult to reach, long treks and expensive rides are necessary to receive essential care. Due to the state of remote villages being located far from hospitals, patients are not able to receive help immediately in case of an emergency.

Lesotho is also the only country in the world that has its entire elevation above 1,000 meters, which means the terrain may be harder to navigate and maneuver. The life expectancy for Lesotho averages around 53 years for both males and females and deaths under 5 occur 8.1% of the time. However, despite all these limitations, Lesotho has remained committed to improving the well-being of its citizens. Partnerships with private companies, expansions to the hospital network and increased government funding to aid programs have all been policies implemented to invest in Lesotho’s health infrastructure. These five facts about healthcare in Lesotho are integral to understanding the country’s changing health structures and transition out of poverty.

5 Facts About Healthcare in Lesotho

  1. Lesotho is at an elevated risk for HIV and Tuberculosis, consistently ranking in the top 20 countries by an estimated absolute number of incident cases. Predictions estimate that less than half of the approximate 12,000 cases of HIV/TB co-infected patients are even diagnosed each year, much less treated for their symptoms. Estimated TB incidence is about 724 per 100,000 individuals in the population, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) reports. Understanding that the necessary objective is to expand TB testing and treatment coverage, Lesotho is working to increase and optimize its GeneXpert equipment to meet the demand.
  2. Partners in Health, known locally to the people of Lesotho as Bo-mphato Litsebeletsong Tsa Bophelo, works directly with the government of Lesotho to reform and improve the healthcare infrastructure system as a whole. After a government invitation in 2006 to aid in Lesotho’s response to the HIV epidemic, Partners in Health expanded a primary healthcare program to reach over 90,000 people at mountain clinics in remote areas of the country. Partnered reform for HIV/TB co-infection began in 2014, with Partners in Health as the primary adviser to the government of Lesotho. Thus far, the expansion of health systems has reached more than 70 health centers and about 40% of Lesotho’s population. With special focuses on maternal and child health going forward, Partners in Health looks to continue Lesotho’s health development.
  3. One of the most unique government healthcare services in Lesotho, the Flying Doctor Service, provides aid by plane to rural areas. However, even in these hard-to-reach mountainous areas, the Flying Doctor Service does more than provide treatment. In addition to emergency medical service, the service also implements healthcare programs and brings essential medical supplies like vaccines to areas in need. The Flying Doctor Service uses Cessna 206 single-engine planes, stocked with stretchers and first aid kits, to deliver care to the people of Lesotho. Even countries like Ireland have supported the Flying Doctor Service in Lesotho, committing to provide flights to Lesotho to assist the aid efforts.
  4. Public-private partnerships have been an essential part of Lesotho’s healthcare development in the infrastructure department. The International Finance Corporation of the World Bank has recently been working with the government of Lesotho to develop hospitals and health centers around the mountainous regions. The Queen ‘Mamohato Memorial Hospital in the country’s capital, Maseru, was recently developed and opened for patients. Replacing the Queen Elizabeth II Hospital, where infrastructure was debilitating and services were poor, the new Queen ‘Mamohato Memorial Hospital is truly world-class. With state of the art operating rooms, a maternal ward, nursery, Intensive Care Unit and other services, the new hospital built with help from a $6.25 million grant from the World Bank Group.
  5. In 2016, the maternal mortality rate in Lesotho was about 618 deaths per 100,000 live births. Though this mortality rate is favorable when compared to the 2014 statistic of approximately 1,024 deaths per 100,000 live births, it is still too much too high for Lesotho. This exceptionally high maternal mortality rate is a result of the poor services provided during pregnancy, childbirth and after delivery (especially to those in rural areas of Lesotho). Postnatal care is also imperative to ensure the safety of the mother and child after delivery but only around 62% of mothers and 18% of newborns receive the recommended treatment.

In the fight against poverty and for a stronger healthcare system, Lesotho has much work to do. There has been progress on the infrastructure front and with public-private partnerships but many services to the rural population still lag behind what is necessary. However, with continued government support and increased foreign aid, the healthcare system will continue to develop and Lesotho can become a country that provides a robust healthcare system for its growing population.

– Pratik Koppikar
Photo: Pikist

Tuberculosis in BotswanaBotswana is a southern African country with just over 2 million residents living inside its borders. Every Batswana lives with the threat of tuberculosis, an infectious disease that remains one of the top 10 causes of death on the African continent. Tuberculosis has a 50% global death rate for all confirmed cases. Investing in tuberculosis treatments and prevention programs is essential. Botswana has one of the highest tuberculosis infection rates in the world with an estimated 300 confirmed cases per 100,000 people, according to the CDC. Preventative and community-based treatment shows promise in combating tuberculosis in Botswana.

Treating Tuberculosis in Botswana

Tuberculosis treatment cures patients by eliminating the presence of infectious bacteria in the lungs. The first phase of treatment lasts two months. It requires at least four separate drugs to eliminate the majority of the bacteria. Health workers administer a second, shorter phase of treatment to minimize the possibility of remaining bacteria in the lungs.

Early identification of tuberculosis is a crucial step in the treatment process and significantly reduces the risk of patient death, according to the Ministry of Health. Preventative treatment methods are vital because they inhibit the development of tuberculosis infection. They also reduce the risk of patient death significantly.

Health workers detect tuberculosis with a bacteriological examination in a medical laboratory. The U.S. National Institutes of Health estimate that a single treatment costs $258 in countries like Botswana.

Involving the Community

Botswana’s Ministry of Health established the National Tuberculosis Programme (BNTP) in 1975 to fight tuberculosis transmission. The BNTP is currently carrying out this mission through a community-based care approach that goes beyond the hospital setting. Although 85% of Batswana live within three miles of a health facility, it is increasingly difficult for patients to travel for daily tuberculosis treatment. This is due to the lack of transportation options in much of the country.

Involving the community requires the training and ongoing coordination of volunteers in communities throughout the country to provide tuberculosis treatment support. Community-based care also improves treatment adherence and outcome through affordable and feasible treatment.

The implementation of strategies such as community care combats tuberculosis. For example, it mobilizes members of the community to provide treatment for tuberculosis patients. The participation of community members also provides an unintended but helpful consequence. For example, community participation helps to reduce the stigmas surrounding the disease and reveals the alarming prevalence of tuberculosis in Botswana.

A Second Threat

In addition to the tuberculosis disease, the HIV epidemic in Africa has had a major impact on the Botswana population, with 20.3% of adults currently living with the virus. Patients with HIV are at high risk to develop tuberculosis due to a significant decrease in body cell immunity.

The prevalence of HIV contributes to the high rates of the disease. The level of HIV co-infection with tuberculosis in Botswana is approximately 61%. African Comprehensive HIV/AIDS Partnerships (ACHAP), a nonprofit health development organization, provides TB/HIV care and prevention programs in 16 of the 17 districts across the country in its effort to eradicate the disease.

Fighting Tuberculosis on a Global Scale

The World Health Organization (WHO) hopes to significantly reduce the global percentage of tuberculosis death and incident rates through The End TB Strategy adopted in 2014. The effort focuses on preventative treatment, poverty alleviation and research to tackle tuberculosis in Botswana, aiming to reduce the infection rate by 90% in 2035. The WHO plans to reduce the economic burden of tuberculosis and increase access to health care services. In addition, it plans to combat other health risks associated with poverty. Low-income populations are at greater risk for tuberculosis transmission for several reasons including:

  • Poor ventilation
  • Undernutrition
  • Inadequate working conditions
  • Indoor air pollution
  • Lack of sanitation

The WHO emphasizes the significance of global support in its report on The End TB Strategy stating that, “Global coordination is…essential for mobilizing resources for tuberculosis care and prevention from diverse multilateral, bilateral and domestic sources.”

– Madeline Zuzevich
Photo: Flickr

World TB Day

World Tuberculosis Day is held on March 24 annually to honor the date in 1882 that Dr. Robert Koch announced his discovery of the bacillus that causes the illness, Mycobacterium tuberculosis. The theme of World TB Day 2016 is “Unite to End TB.”

The Threat of Tuberculosis

The World Health Organization (WHO) states that tuberculosis or “TB” still kills more people today than any other communicable disease. In 2014, over 9.6 million people contracted TB and 1.5 million died from the disease. Over 1 million children fell ill with TB and 140,000 died from the disease.

In addition, the WHO reports that low to middle-income countries are the hardest hit in terms of annual TB cases. With more than one-quarter of all TB cases occurring in Africa, USAID has partnered with African Strategies for Health to develop a plan to deal with the epidemic of childhood TB in 12 African countries.

The analysis includes ideas (1) to fortify the ability of healthcare workers to diagnose children infected with TB; (2) to help with early identification of child TB, delays in diagnosis cost lives; and also (3) to make sure that there is treatment close to home.

MDG Improving TB Treatment

The WHO points out that there has been much advancement in the treatment of TB since the announcement of the Millennium Development Goals (MDGs) of the United Nation (UN). TB infection has fallen by an average of 1.5% per year since 2000 and is now 18% lower than in 2000. The death rate dropped almost 50% between 1990 and 2015 and approximately 43 million lives have been saved through TB treatment between 2000 and 2014.

In addition, the Millennium Development Goals for the treatment of TB by 2015 have been reached. Ending the TB epidemic by 2030 is among the health targets adopted by the U.N. Goal #3 of the Sustainable Development Goals to “ensure healthy lives and promoting well-being for all at all ages.”

TB is an airborne disease and relatively easy to contract and is often misdiagnosed. However, the disease is preventable. The WHO’s strategy is to cut new cases of TB by 80% and to reduce TB deaths by 90% between 2015 and 2030. The organization also want to ensure that no family affected by TB faces financial ruin.

Rhonda Marrone

PakistanOn March 17, Pakistan was honored with an award from the United States, naming the country the most successful in fighting multi-drug resistance tuberculosis (MDR-TB).

The award is significant for Pakistan, the fifth country most highly burdened by TB and the fourth most by MDR-TB, according to the World Health Organization (WHO). Although 9.6 million people globally become sick with TB each year and the number in Pakistan was 298,981 in 2013, the percentage of successful treatments has also continued to increase.

In 2001, Pakistan declared TB a national health crisis, putting the country in a state of emergency. In collaboration with the Ministry of Health and the National TB Control Program (NTP), Pakistan set objectives to facilitate improved treatments and lower incidence rates. NTP vowed to increase the number of notified TB cases, while still maintaining treatment success rate at 91 percent, and to reduce, by at least five percent per year, the prevalence of MDR-TB among TB patients who have never received any TB treatment.

The connection between poverty and TB incidence cannot be overlooked. Ninety-five percent of new TB cases and 98 percent of TB related deaths annually occur in the developing world. In Pakistan, 75 percent of TB cases fall among young people, aged 15-45, in the country’s poorest regions, according to the “TB Patients’ Declaration on TB,” a document signed at the First TB Patient Symposium in October 2014.

Since its pledge, the NTP has successfully treated more than 1.5 million TB cases, free of cost. Strategies for fighting eradication of poverty and the disease, and to minimize economic restraints on the country, have been vital to the movement’s success.

Dr Jim Yong Kim, President of the World Bank, spoke on behalf of the organization in Washington, emphasizing the need for treatment among patients categorized as low economic priority. “I am yet to meet a patient who says, please do not treat me because I am a low priority patient,” he noted.

Other presenters at the ceremony, including Ambassador Jalil Abbas Jilani, winner of the TB Champion Award, and Dr. Ejaz Qadeer, the national manager for the TB Control Programme, emphasized the growing need for not only cost-efficient treatment, but also early detection mechanisms, so as to prevent the virus from transferring from patients in crowded areas. As the country with the highest MDR-TB success rate, Pakistan plans to achieve 80 percent detection by 2020.

Between 1990 and 2015, the TB death rate has dropped 47 percent, according to WHO. With leaders like Pakistan, the rest of the world could hope for a global end of the disease.

Nora Harless

Sources: Dawn News, The Express Tribune, National TB Control Program, Target Tuberculosis, World Health Organization
Photo: Flickr

Ghana
The president of Ghana announced at a ceremony earlier this month that the West African nation’s government has signed new grants with Global Fund, an international financing organization that invests around $4 billion a year to support programs fighting AIDS, malaria and tuberculosis (TB).

The seven new grants, totaling $248 million, come from many supporters, including the U.S. President’s Emergency Plan for AIDS Relief, the U.K. Department for International Effort, the European Union, Denmark, Korea, UNICEF, UNAIDS and WHO, among others.

The primary objective of the grants is to increase how many people receive protection and treatment for HIV, malaria and TB. Specifically, the key targets address certain aspects of prevention and treatment and aim to complete the goals by 2017.

Among the goals of the grants are for 140,448 people to be assured antiretroviral treatment to control HIV, as well as increase coverage for an additional 32,246 pregnant women.

The funds will also aim to expand services to protect key affected populations from HIV, including 65 percent of female sex workers, 88 percent of homosexual men, and 80 percent of inmates, in addition to providing annual testing services for 20 percent of the general population.

In terms of malaria, the funds will be used to secure treatment for 80 percent of children under five, as well as have mosquito nets in 70 percent of households.

For TB, the goal is to double case notification rates to 103 per 100,000 and make sure 100 percent of drug-resistant patients on second-line treatment are covered for treatment, up from 42 percent in 2013.

Additionally, Ghanaian officials want to use the funds to better integrate treatment for HIV and TB in community health clinics.

The government of Ghana also plans to use domestic funds to cover the expenses for antiretroviral drugs for 22,000 current patients and 11,000 new patients.

The nation was the first to sign a grant with Global Fund, doing so in 2002, seeing advances in overall health as a result.

Since 2010, there has been a 43 percent decrease in new HIV infections, and between 2009 and 2014, there was a 51 percent drop in new infections in children. The percentage of coverage dealing with preventing mother-to-child transmission is now at 81 percent, up from 32 percent.

Successes have also been seen in preventing and treating malaria and TB, as government officials and other organizations have distributed a combined 19 million mosquito nets, as well as detected and treated 76,000 new TB cases and having 88,000 people currently in antiretroviral therapy.

Matt Wotus

Sources: AllAfrica, The Global Fund
Photo: Pixabay

AIDS and TBIn an August 11th press release, the United Nations Development Program (UNDP) announced a $41 million financial injection to Sudan to advance its response to the HIV/AIDS and Tuberculosis (TB) epidemic.

Sudan is an African Country in the Nile Valley of North Africa bordered by Egypt to the north, the Red Sea, Eritrea, and Ethiopia, to the east, South Sudan to the south, the Central African Republic to the southwest, Chad to the west and Libya to the northwest.

Although recent years have seen improvements in the response to HIV/AIDS and TB, the illnesses maintain their death grip on the population.

The UNDP, in collaboration with the Federal Ministry of Health in Sudan and the Global Fund to Fight AIDS, has created two new partnership agreements totaling $41 million for the country to continue fighting the deadly diseases.

The funding is broken into two grants. The first grant worth $20.4 million will be used to manage and track the decrease in TB cases from now until 2017, as well as to commit to identifying more new cases.

By identifying more cases of TB, the disease can be better controlled and spread less. The grant will also go toward improving treatment for 90 percent of newly infected patients as well as for 75 percent of those undergoing a relapse.

The second grant amounting to $20.8 million will go toward halting the spread of HIV among communities most at risk between now and 2017. The grant will also work at keeping the HIV prevalence rate below 2.5 percent among key populations and below 0.3 percent among the general population.

The UNDP, since 2005, has been a key organization assisting Sudan with its ongoing health care challenges. It’s played an important role in decreasing the transmission and morbidity rate of HIV and TB plaguing the Sudanese.

In the past few years, the UNDP has assisted the government with containing the epidemic, increasing service coverage and strengthening the national health system.

The UNDP website reported that the number of people accessing HIV counseling and testing increased from 14,000 in 2007 to more than 250,000 in 2014. In the same period, the number of health facilities providing antiretroviral treatment increased from 21 to 36.

Also, as of 2014, the number of people receiving antiretroviral treatment has increased to 3,937 from only 319 back in 2007.

UNDP Sudan Country Director Mr. Selva Ramachandran was quoted in the press release to say, “UNDP’s goal is to strengthen the response at the national, state and local level by supporting the development of local expertise and backstopping program performance.

To get TB under control, the authorities are planning to provide social support to patients and develop a national campaign to fight the stigma and discrimination that severely hinders TB efforts. Regarding HIV, testing is essential to bend the curve of the epidemic and we remain committed to supporting the provision of HIV testing, counseling and treatment to those in need.”

In nations like Sudan, poverty grips the population and health care can be almost nonexistent. With the help of the UNDP and the extra funding given, the fight to help the poor in Sudan has again gained momentum, and another dent in ridding these ugly diseases has been made.

Jason Zimmerman

Sources: United Nations Development Programme, The Global Fund,
Photo: Flickr

Tuberculosis (TB) is often forgotten as a global health threat, but recent advances in molecular technology have health officials optimistic about the future.

It is estimated that one-sixth of all annual deaths caused by infectious diseases result from TB. The second-largest killer behind HIV/AIDS, the disease kills an estimated 4,000 people a day. Sub-Saharan Africa experiences the worst of it, as the infectious disease is the most common cause of death among HIV-positive people. Estimates say that over 1,000 people with HIV die from TB every day.

One of the biggest problems when it comes to TB is detection. Currently, HIV-associated TB is being detected in only half of the estimated number of people who have it. Another issue that arises is weak healthcare coverage, which places an economic burden on poor people. Additionally, a lack of healthcare coverage has an effect on people’s vulnerability to TB and health outcomes from the disease.

However, progress in the fight against TB has been seen over the past two decades. The TB mortality rate fell between 1990 and 2013 by an estimated 45%. In that time, over 60 million people were cured from the disease and 37 million lives were saved. Most of the success has been attributed to a rise in new technology. In fact, such interventions are said to not only save lives, but to be cost-effective, because for every dollar spent there is an estimated $30-$43 return.

Cepheid Inc., a diagnostics company based in California, created one such revolutionary piece of technology. Dubbed GeneXpert, the automated molecular technology has been said to be one of the most significant achievements in decades in regards to TB research.

The device is more accurate and faster than traditional diagnosis methods, such as the out-of-date smear microscopy, which was created a century ago. GeneXpert works by allowing health workers to place gathered sputum samples in cartridges, which in turn are connected to a computer. As a result, the DNA of TB bacteria can be detected within two hours. The device can also identify multidrug-resistant forms of TB.

In addition to being endorsed by the World Health Organization, it attracted the attention of global donors. Many poured in donations to help distribute it around the world.

In May, a study conducted in India showed that by using GeneXpert, the number of bacteriologically confirmed cases increased by 39%.

The problem with the technology, however, is its expense.

Poor people in the developing world, those who are most likely to need GeneXpert, have trouble getting necessary access to the technology. While donors across the world are taking care of the $17,000 price tag associated with each machine, countries are struggling to pay for the cartridges. Each cartridge costs $10, meaning some countries cannot purchase them on a large scale because of a lack of funds. Additionally, GeneXpert requires access to electricity, computers and refrigeration, a difficulty for many TB-prevalent areas.

Even with some of these issues, health officials are still excited with the recent activity. The creation of GeneXpert, as well as rather large investments in the device, have led to more companies starting to develop diagnostic technologies. The hope is that some of these technologies will eliminate the downsides of GeneXpert. According to a report by UNITAID, a global health initiative, there are currently 81 manufacturers running tests with almost 200 potential new products having to do with TB diagnostics.

One such company is Alere Inc. The diagnostics company, based in Massachusetts, is working on a transportable test that would be powered by batteries, giving it the capability of being used portably for an entire day. With the test being portable, the company says that health workers would then have the ability to decide about treatments on the spot, the same place where the diagnosis was made.

The company, which received a $21.6 million grant from the Bill and Melinda Gates Foundation, is also working to make the costs of its machine and cartridges less expensive than GeneXpert.

While questions still remain, as Alere has yet to run any type of trials on its technology, those devoted to the fight against TB are still hopeful about the future. Through boosted investments and partnerships between public and private sectors, revolutionary technology has, and will continue to, aid the fight against tuberculosis.

– Matt Wotus

Sources: The Hill, New York Times
Photo: Dr. Dang’s Lab

Kyrgyz USAID Tuberculosis
How can a government ensure that resources devoted to health are used efficiently and effectively? Which performance-based incentive is really providing the desired outcome? How responsive are health policies to the actual needs of its target community? The Health Finance and Governance (HFG) project was launched by USAID in 2012 to help answer these questions. It is a five year- 209 million dollar global project to improve health finance and health governance in partner countries. The end goal is to improve health outcomes and access to health care, as well as generate evidence on the most efficient improvements to health management.

HFG works on five broad topics relating to financing health projects: transparency and accountability, pricing and management, development of evaluation metrics, and capacity building. Perhaps the single most important factor in dealing with these issues is that local, regional and cultural aspects contribute to the problems and the solutions. No one solution can fit all countries or even all target populations within one country. Let us consider just one example of HFG’s work.

In 2013, the Kyrgyz Republic had a tuberculosis (TB) incidence rate of 141 for every 100000 people. It is among the countries suffering from the most high multi-drug resistant TB (MDR-TB) burden in the world, yet TB detection rate at 66 percent, and drug susceptibility testing coverage, at 25 percent is still low. The WHO cites poor coordination of TB data management, insufficient oversight of treatment and monitoring of adherence to treatment, and non-compliance by patients and health providers to the prescribed antibiotic regimen as well as poor infection control as causes for rampant prevalence of TB and the spread of MDR-TB.

In the 1990s, the Kyrgyz Republic transitioned its general hospital system to case-based financing, where funds are provided to a hospital based on the previous years bed occupancy levels. This incentivized hospitals to increase hospitalizations, which not only is not always required leading to ineffective use of funds, but also exposes the patient to an infection-rich environment where depressed immune systems can acquire secondary, drug resistant infections.

The HFG assisted the Kyrgyz Republic to transition to a financing system that is based on the number of patients treated. Under this model, the hospital would receive a set fees for complicated MDR-TB cases and a lower fees for less complicated cases. This kind of financing structure also stimulated hospitals to require bacterial confirmation of the disease as opposed to a more subjective clinical diagnosis, which would reduce the number of cases treated in error. To complete this transition successfully, the government had to be fully involved to ensure that finances saved by reduced hospitalizations would be reinvested to provide better support for TB outpatient services like patient transportation, supplies, and social support.

In this region, this kind of approach integrates well with more standard approaches of launching rapid diagnostics like the work done by the National TB program and TB Reach, or providing access to new antibiotics like the End TB Erogram run by Partners In Health, Medecins Sans Frontieres, Interactive Research and Development and UNITAID. There is still a long way to go and a lot of gaps to fill. As about 44 percent of the financing for TB projects in Kyrgyzstan comes from foreign aid, assistance in mobilizing domestic resources can make health projects more sustainable. This would parallel the work of HFG in Nigeria where it is working to increase the resource mobilization capacity to support HIV/AIDS treatment.

When the various arms of the government work effectively with each other and with private sector and donor organizations, inefficiencies and wastage in development projects can be resolved. However, the first step remains identifying these gaps and designing novel solutions to fill them. When the HFG completes its term in 2017, a full measure of its successes can guide further development decisions.

Mithila Rajagopal

Sources: HFG, Medecins Sans Frontiers, StopTB, WHO, The World Bank
Photo: USAID

Drug-Resistant _TB
Several are in shock about the tuberculosis situation in South Africa and no solution has been given. Patients who have drug-resistant tuberculosis are being sent home despite the high likelihood that they will transmit it to their family members. These findings have been released after a study was published in the medical journal, The Lancet.

According to the report, 107 patients were monitored while they were treated for tuberculosis. Out of these people, 78 died in spite of being treated with six drugs to 10 drugs. These South African patients who were diagnosed as untreatable but infectious were discharged due to insufficient beds in hospitals. Several doctors are advocating for funding so that patients can be treated away from the community. Tuberculosis is highly infectious and can just as easily spread like the flu, ultimately infecting the lungs and potentially causing death.

South Africa does not have advanced treatments for tuberculosis and according to the World Health Organization, 450,000 people have multi-drug resistant tuberculosis in Eastern Europe, Asia and South Africa. Research professors are in support of reintroducing old sanatoriums so that these patients will have comfort and long-term care while they struggle with the untreatable disease. According to The Lancet, 42 percent of patients being sent home have drug-resistant tuberculosis. In several cases they were being sent back to their one bedroom homes shared with children and other family members.

Keertan Dheda, a professor of medicine in Cape Town reports that new drugs are urgently needed. Most tuberculosis patients may live for more than a year and are risking the lives of others they come in contact with during that time. Those with virtually untreatable tuberculosis, XDR-TB, pose extreme danger to communities. In one case, one patient passed on the infection to his brother and both died.

Such cases have led to global strategies in the past with development of new forms of tuberculosis control. Due to the current lack of funding, the situation does not look promising. There is a large need for investments in drug development and diagnostics for global tuberculosis research.

-Maybelline Martez

Sources: The Guardian, Reuters
Photo: MSF

TBcrisis_opt
The WHO has recently reported that there is a global failure to prevent the spread of multidrug-resistant tuberculosis (MDR-TB), which affects an estimated three million people not receiving treatment due to living in distant rural areas in developing nations. In fact, more than 95 percent of tuberculosis deaths occur in poor countries, and it is the second greatest killer worldwide after HIV/AIDS.

According to the WHO, about 16,000 individuals were diagnosed in 2012 with TB worldwide, but were not provided adequate treatment to control the disease and stay alive. The Organization also stated that 1.3 million people died in 2013 from MDR-TB, a drop from the 1.4 million in 2011, but the disease still contributes to the global public health crisis.

Doctors Without Borders (DWB) has also responded to the multidrug-resistant tuberculosis crisis but has stressed the continued lack of drug supplies or trained professionals to help save lives as the main causes for the large number of MDR-TB cases.

Additionally, as the number of cases increases, the waiting lists for costly and extensive treatment processes does to. In fact, it can take two years for someone to be cured, causing many countries’ cure rates to remain low.

According to a recent article published by The Guardian, DWB TB program director Dr. Mario Raviglione was quoted saying, “the unmet demand for a full scale and quality response to multidrug-resistant tuberculosis is a real public health crisis. It is unacceptable that increased access to diagnosis is not being matched by increased access to MDR-TB care. We have patients diagnosed but not enough drug supplies or trained people to treat them. The alert on antimicrobial resistance has been sounded; now it is the time to act to halt drug-resistant TB.”

In order to tackle the problem, the WHO calls for the official labeling of drug-resistant TB as a “public health crisis.” Additionally, there should be a greater capacity to diagnose the disease, as well as increased supply of necessary medicines and an improvement in a country’s ability to provide care for citizens affected. The report also acknowledges that in order for these advances to be made, there needs to be “high-level political will and leadership and more collaboration among partners, including drug regulatory authorities, donor and technical agencies, civil society, and the pharmaceutical industry.”

The report mentioned that $6 billion was made available for TB care in 2013, however an additional $2 billion a year is what is needed to ensure sustainable progress.

– Elisha-Kim Desmangles
Feature Writer

Sources: The Guardian, The Huffington Post, WHO
Photo: Oddny Blog