Tuberculosis
Tuberculosis (TB) kills approximately two million people each year, and more than eight million become sick with the disease. That number is going up all the time. The breakdown in health services in poorer countries, the spread of HIV and AIDS and the emergence of multidrug-resistant TB are contributing to the worsening impact of this disease. TB is a contagious disease and is spread by coughing and sneezing. The best way to prevent TB is to treat and cure the people who have it, to stop them from spreading it. Every 15 seconds someone dies of TB, but almost everyone could have and should have been cured.
The highest number of estimated deaths from TB is in South-East Asia. The disease is also having a huge impact in Africa, where HIV has led to rapid increases in the incidence of TB and increases the likelihood of dying from TB. HIV and TB form a deadly combination, each increasing the other's impact. HIV weakens the immune system, making it more likely that someone will be susceptible to TB.
Poverty, a lack of basic health services, poor nutrition, and inadequate living conditions all contribute to the spread of TB. In turn, illness and death from TB reinforces and deepens poverty in many communities. TB disproportionately affects the poor, who are more vulnerable to infection and suffer more from the consequences of the disease.
Prevention and Care
TB infection can be prevented, treated and contained. The World Health Organisation recommends an inexpensive strategy for detection and cure called DOTS (Directly Observed Treatment Short Course), which could prevent millions of TB cases and deaths. DOTS combines five elements: political commitment, detection of cases, reliable drug supplies, use of highly effective medicines with direct observation of treatment, and systems for monitoring outcomes. Drugs for DOTS can cost only US$10 per person for the full treatment course (six to eight months). The World Bank has ranked the DOTS strategy as one of the
most cost-effective of all health interventions
.
DOTS prevents the disease from spreading by curing infectious patients. Health workers observe patients swallowing the full course of the correct dosage of anti-TB medicines. This prevents the development of drug resistance (caused by inconsistent or partial treatment), by ensuring that the full course of treatment is followed.
The World Health Organisation has set TB-control goals for 2005, to detect and treat more cases worldwide. However, there are several obstacles to be faced. TB is spreading faster than TB-control efforts, and urgent action is required to mobilise sufficient resources, public awareness and political commitment to halt it. Particularly worrying is the emergence of HIV-associated TB and multi-drug resistant TB.