TB challenge requires collective regional approach: ministers

At a meeting held in Maputo, Mozambique, the ministers agreed that the free movement of people between SADC countries could compound the spread of the disease in the region.

The World Health Organization (WHO), too, has expressed concern over the emergence of virulent drug-resistant strains of tuberculosis (TB) and is calling for measures to be strengthened and implemented to prevent the global spread of the deadly TB strains.

This follows research showing the extent of XDR-TB, a newly identified TB threat which leaves patients (including many people living with HIV) virtually untreatable using currently available anti-TB drugs.

MDR-TB (Multidrug Resistant TB) describes strains of tuberculosis that are resistant to at least the two main first-line TB drugs – isoniazid and rifampicin. XDR-TB, or Extensive Drug Resistant TB (also referred to as Extreme Drug Resistance) is MDR-TB that is also resistant to three or more of the six classes of second-line drugs.

The description of XDR-TB was first used earlier in 2006, following a joint survey by WHO and the US Centers for Disease Control and Prevention (CDC).

Resistance to anti-TB drugs in populations is a phenomenon that occurs primarily due to poorly managed TB care. Problems include incorrect drug prescribing practices by providers, poor quality drugs or erratic supply of drugs, and also patient non-adherence.

XDR-TB poses a grave public health threat, especially in populations with high rates of HIV and where there are few health care resources. Recommendations outlined in the WHO Guidelines for the Programmatic Management of Drug Resistant Tuberculosis include strengthen basic TB care to prevent the emergence of drug-resistance ensure prompt diagnosis and treatment of drug resistant cases to cure existing cases and prevent further transmission increase; collaboration between HIV and TB control programmes to provide necessary prevention and care to co-infected patients increase investment in laboratory infrastructures to enable better detection and management of resistant cases.

To help curb the problem or spread of the disease, ministers agreed on a regional cooperation and information-sharing approach between countries.

This would be done through the SADC secretariat.

Strengthening surveillance systems, infection control and diagnostics techniques for TB were some of the other resolutions agreed upon.

One of the challenges put forward at the conference was the limitations of drugs owing to the fact that no new TB drugs and diagnostic tests had been developed in the past 30 years.

“This makes XDR-TB much more difficult to treat … and could even lead to the recalling of the drugs that were taken off shelves due to their side effects and toxicity.”

Ministers therefore agreed to encourage the pharmaceutical industry to develop new drugs and diagnostic techniques for the effective treatment of the disease: “A preparedness plan on XDR-TB needs to be developed within member states and at regional levels to deal with the challenge.” ‘ Sapa/own/WHO.

October 2006
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