AP/Google.com examines efforts to address drug-resistant tuberculosis in China, other countries

Mar 30 2009

The AP/Google.com on Monday examined efforts to prevent and control the spread of drug-resistant tuberculosis in China and other countries.

According to the AP/Google.com, drug-resistant TB often develops when health care systems fail to ensure proper treatment adherence, which allows TB bacteria to develop resistance to first-line medications. Multi-drug resistant TB is resistant to two of the most potent first-line treatments, and extensively drug-resistant TB additionally is resistant to at least two of the classes of second-line drugs.

According to the AP/Google.com, the World Health Organization on Wednesday in Beijing launched launch a three-day Ministerial Meeting of High M/XDR-TB Burden Countries. Health ministers from countries with high burdens of MDR- and XDR-TB are expected to develop plans to prevent and control drug-resistant TB in their respective countries. In addition, WHO Director General Margaret Chan and Bill Gates of the Bill & Melinda Gates Foundation will participate in the event.

According to the AP/Google.com, of the 500,000 people worldwide with drug-resistant TB, about 25% live in China. In addition, although 112,000 people in China have drug-resistant TB, only a few thousand are receiving proper treatment, according to health experts. According to the AP/Google.com, China's health system has insufficient funding to monitor every TB patient, and the majority of the country's 130 million migrants from rural areas do not qualify for the no-cost treatment provided to urban residents. In addition, Medecins Sans Frontieres reports that it encountered obstacles in implementing a drug-resistant TB program in Inner Mongolia because of the Chinese government's demands. "We are rather frustrated about it," Luc van Leemput, MSF's operational coordinator in Brussels, Belgium, said, adding that he hopes the "Chinese government is going to get its act together and provide access to treatment for those patients who need it."

Despite the challenges of China's disease burden, the country has made some progress in addressing TB, which until last year was the most fatal infectious disease in the country, the AP/Google.com reports. China currently has an Internet-based reporting system to help health workers refer TB patients to special facilities run by the country's communicable diseases agency. In addition, China is developing an electronic system to track migrants with the disease, Cornelia Hennig, WHO's TB program coordinator for the country, said. The Chinese government also has pledged to improve the country's health care system with a $124 billion investment over the next three years. Furthermore, China's Ministry of Health is conducting a national survey of people with drug-resistant TB and plans to provide treatment for these populations, although it has not indicated when this program will begin. According to the ministry, treating drug-resistant TB is 100 times costlier than treating standard TB.

According to the AP/Google.com, drug-resistant TB also poses challenges in other high-burden countries such as India, where rural health care facilities often do not have adequate resources and the government exercises little control over the sale of TB drugs. Russia also faces a shortage of health workers and medicines, and the TB burden in South Africa is particularly prevalent among people living with HIV, the AP/Google.com reports.

According to Mark Harrington, executive director of the Treatment Action Group, fewer than 5% of people with drug-resistant TB worldwide receive proper treatment. Harrington said, "So most of the people are going around coughing and spreading multi-drug resistant TB. But most countries have not yet started to take it seriously." Although developing countries generally face the highest TB burden, the disease could begin to spread worldwide as international travel and immigration increases. According to the AP/Google.com, even as TB prevalence declines in the U.S., drug-resistant strains have emerged in states such as California that have large immigrant populations from countries such as China, India and Mexico (Wong, AP/Google.com, 3/30).