Washington DC
SHOCKING new figures have confirmed repeated warnings that drug-resistant
tuberculosis is breaking out in 鈥渉ot zones鈥� all over the world, says the WHO. If
efforts to treat TB are not stepped up, resistant strains will spread
rapidly鈥攑lacing impossible demands on the healthcare systems of poor
countries.
The first worldwide survey of drug-resistant TB reveals that 10 per cent of
the 6 to 8 million new cases recorded each year are resistant to at least one of
four major drugs. Two per cent are resistant to two or more drugs. 鈥淲e stand at
the edge of the millennium, facing the spectre of incurable TB,鈥� says Arata
Kochi, director of the WHO鈥檚 Global TB Programme.
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Multidrug-resistant TB was reported in all 35 countries surveyed. But the
worst hot spots were in India, Russia, Latvia, Estonia, the Dominican Republic,
Argentina and C么te d鈥橧voire. There many TB patients don鈥檛 take a complete
course of drugs, increasing the likelihood that the bacterium, Mycobacterium
tuberculosis, will become drug resistant.
The danger, says Michael Iseman, a TB expert at the National Jewish Medical
and Research Center in Denver, is that resistant TB will spread from these zones
into other areas where drug treatment is similarly patchy.
To prevent this happening, the WHO wants TB patients to be given a
combination of four drugs and be monitored for six months to ensure that they
finish the course. This would cure most patients infected with standard strains
of M. tuberculosis. And while it won鈥檛 directly help most patients with
drug-resistant TB, it will slow the rise of drug-resistant strains.
The recommended treatment costs up to $200 per patient in developing
countries. Launching programmes to extend the treatment worldwide will cost
$100 million, roughly ten times the WHO鈥檚 current annual budget for TB
control. That sounds expensive, but treating drug-resistant cases costs 100
times as much鈥攚hich many countries cannot afford.