PAHO News Index:
http://www.csih.org/Pahonews/index.html
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PAHO Calls for Access to Tuberculosis Drugs for all
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Washington, March 22, 2001 -- The Pan American Health Organization is
marking World Tuberculosis Day March 24 with a call for access to
tuberculosis drugs and services for all in order to halt the spread of the
disease.
Dr. George Alleyne, Director of the Pan American Health Organization, said
the slogan of the celebration: "DOTS, TB cure for all" conveys the best way
to continue the struggle against tuberculosis, using the widely accepted
Directly Observed Treatment, Short-course, strategy known as DOTS.
"We must ensure access to health services and equity of care for all who
need it, men women and children, using the DOTS strategy to ensure that
everyone who is diagnosed with TB is treated for it," Dr. Alleyne said.
The objectives of the campaign are to mobilize political leaders and
decision-makers about the situation of TB sufferers, the implications of TB
for human development, and to raise awareness that a cure for TB is
available and that accessing and completing TB treatment, without stigma
and discrimination, is an important step in realizing one's right to the
highest attainable standard of health and well-being. World TB Day
commemorates the date in 1882 when Dr. Robert Koch announced the discovery
of the TB bacillus. It is designed to raise awareness about the continuing
international health threat posed by TB, which, like the common cold, is
airborne. It spreads when an infected person coughs, spits or sneezes. It
can attack a number of organs but mostly affects the lungs.
Dr. Alleyne added that it is important to note that three of four people
affected by TB are young adults, and many of them also acquire AIDS.
Tuberculosis is the leading cause of death among HIV-positive people and
the risk of developing TB by HIV positive people is 30 times greater than
by HIV negative persons.
Dr. Rodolfo Rodriguez, PAHO's regional adviser on tuberculosis, said this
World TB Day aims to mobilize the Region's political leaders and other
decision-makers in order to sensitize them to the situation of people
afflicted by TB, and to the fact that passivity hinders the struggle
against TB. He said "We must increase the awareness that there is a cure
for TB and that access to treatment, without stigma or discrimination, is
an important step toward the full enjoyment of the right that every person
has.
In 1999, 238,082 persons with TB were reported in the region, an incidence
of 29 per 100,000 population. 33 percent of the cases were in Brazil and 18
percent in Peru, Dr. Rodriguez said. He noted that eight countries in the
region with the greatest TB burden make up 75 percent of all TB cases.
These are Brazil, Bolivia, Ecuador. Haiti, Honduras, Mexico, Peru and the
Dominican Republic. It is estimated that one third of patients are not
diagnosed, running a risk of contracting the disease and dying without
treatment.
Dr. Rodriguez said countries that successfully use the DOTS strategy manage
to cure 83 percent of infectious cases, while the countries that do not
apply it as soon achieve 43 percent cure rates. PAHO's goal is to extend
coverage with the strategy in all countries where TB is an important
problem. Although the level of multi drug resistant TB is not high in the
region, some countries show figures that constitute a serious threat to the
patients of that and other countries, he added.
The success of the application of the DOTS strategy in the Region of the
Americas can be seen in Peru, where the incidence of the disease was
reduced by 50 percent; similar reductions were observed in Cuba, Chile,
Nicaragua and Uruguay. Dr. Rodriguez said measures to control TB should be
a daily agenda of the ministries of health and Governments of the
countries, with effective community information, education, and
communication activities.
For more information please call Daniel Epstein at the Pan American Health
Organization Office of Public Information, Tel (202) 974-3459, e-mail:
[log in to unmask] Internet: www.paho.org/news
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REPORTED NEW CASES AND TB RATES
IN THE REGION OF THE AMERICAS, 1999 (RATE PER 100,000 POP.)
Countries Total Cases Rates Smear positive Rates
Argentina 11,871 32.5 5,762 15.8
Bolivia 9,272 114 6,506 80
Brazil 78,628 48 41,434 25
Chile 3,429 23 1,679 11
Colombia 10,999 26.5 8,329 20
Costa Rica 745 21 567 16.5
Cuba 1,111 10 720 6.4
Dominican Republic 5,320 63.6 2,936 35.1
Ecuador 7,027 57 5,149 41
El Salvador 1,623 27 1,023 17
Guatemala 2,820 25 2,264 20
Haiti 9,125 114 6,750 84
Honduras 4,264 72 2,367 40
Jamaica 115 4.57 92 3.5
Mexico 19,802 20.2 13,452 13.7
Nicaragua 2,558 51 1,564 31
Panama 1,365 49 1,178 42
Paraguay 2,115 39 963 18
Peru 41,730 165 24,511 97
Suriname 93 22.4 37 8.9
Trinidad and Tobago 152 11.7 86 6.7
United States 17,531 6.4 6,252 2.3
Uruguay 627 20 384 12
Venezuela 5,760 24 3,670 15
TOTAL 238,082 29.3 137,675 16.8
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WORLD TB DAY 2001: ACCESS TO TB CURE A HUMAN RIGHTS IMPERATIVE
(Joint UNAIDS/WHO Press Release - WHO/14 - 22 March 2001)
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TB and HIV Linked, Joint Efforts Needed
Joint efforts are needed to confront tuberculosis (TB) and HIV, according
to Dr Gro Harlem Brundtland, Director-General of the World Health
Organization. TB is a leading killer of people living with HIV and it is
highest in countries with the highest rates of HIV.
"Not only is this a health imperative - it is fundamental to human rights.
TB and HIV are both enhanced by poverty, homelessness, substance abuse,
psychological stress, poor nutritional status, crowded living conditions,"
Dr Brundtland added, referring to a new report on TB entitled "A human
rights approach to tuberculosis".
The new report was released in the lead-up to World TB Day 2001, on 24
March. Its theme, 'DOTS: TB cure for all', calls for equitable and
discrimination-free access to adequate treatment and services for anyone
who has TB.
HIV and TB are closely linked. Testing in a number of developing countries
shows that up to 70% of TB patients are infected with HIV. In addition, up
to 50% of people living with HIV can expect to develop TB. Worldwide, 36.1
million people are infected with HIV and 95% of them live in developing
countries, where TB rates are highest. About 13 million people are infected
with both HIV and the germ that causes TB.
"People with both diseases suffer double discrimination," said Dr Peter
Piot, Executive Director of the Joint United Nations Programme on HIV/AIDS
(UNAIDS). "HIV severely weakens the immune system, and makes people highly
vulnerable to diseases such as TB. According to our latest figures, nearly
two thirds of all people with HIV or AIDS were living in the countries with
the highest TB burden in the world. The link between the two is
inescapable, and TB is the first manifestation of AIDS in more than half of
all developing country cases."
TB has serious human rights implications. Most major human rights treaties
protect against discrimination in access to health care. However, TB hits
hardest in areas of the world where access to treatment is an unaffordable
luxury. The poor are made even poorer by TB as people fall sick and income
is lost in marginal households.
TB, unlike HIV, can be cured, even in people with HIV infection. A simple
strategy called DOTS cures most people with TB and the drug costs as little
as US$ 10-15 per patient. Untreated, a single person with contagious TB can
infect between 10-15 people a year.
In March last year, a ministerial conference in Amsterdam endorsed a global
target to detect 70% of new TB cases and cure 85% of those detected by
2005. The G8 summit in Okinawa endorsed the commitment to reducing TB by
agreeing to reduce the global burden of TB by half by 2010. In spite of the
commitments and some significant successes, resources allocated to fighting
TB remain insufficient.
"If present trends continue, the target of 70% case detection under DOTS
will not be reached until 2013. It is shameful that with such a cheap and
effective cure available, so many people must continue to die of TB," Dr
Brundtland said. "Our campaign this year reflects the important role of
governments and the private sector in providing TB drugs and services, and
calls on civil society to create the necessary conditions for everyone with
TB to seek treatment."
There were an estimated 8.4 million new cases of tuberculosis in 1999, up
from 8 million in 1997. This increase is due largely to a 20% rise in
incidence in African countries most affected by AIDS. If these trends
continue, some 10.2 million new cases could occur each year by 2005.
"Effectively treating TB will not solve the worldwide AIDS crisis, but it
will significantly reduce its burden," said Dr. Piot.
Globally, 12% of TB patients are infected with HIV. For those countries in
Africa with high HIV prevalence, the estimate is 45%. HIV is also fuelling
TB in parts of Asia, which has about 60% of all TB cases. Industrialized
nations, once almost free of TB, are seeing a resurfacing of the epidemic.
A danger facing all countries is the emergence of new strains which are
resistant to many drugs and cannot be treated cheaply.
TB, like the common cold, is airborne. It spreads when an infected person
coughs, spits or sneezes. It can attack a number of organs but mostly
affects the lungs.
Last year, the UNAIDS Secretariat officially joined the 'Stop TB'
initiative, a broad partnership spearheaded by WHO to halt the spread of
tuberculosis around the world.
For more information or interviews please contact: Mr Gregory Hartl, WHO
Spokesperson, WHO, Geneva. Telephone (+41 22) 791 4458. Fax (+41 22) 791
4858. Email: [log in to unmask] <mailto:[log in to unmask]>. All WHO Press
Releases, Fact Sheets and Features as well as other information on this
subject can be obtained on Internet on the WHO home page
<http://www.who.int/>
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The theme for World TB Day 2001, 'DOTS - TB cure for All', calls for
equitable access to TB services for anyone who has TB, free from
discrimination - rich or poor, man or woman, adult or child, imprisoned of
free, and including other vulnerable groups such as people with HIV or drug
resistant TB.
TB cure for all contributes to the fulfillment of everyone's right to the
enjoyment of the highest attainable standard of health.
More information about World TB Day 2001:
http://www.stoptb.org/world.tb.day/WTBD_2001/Index.htm is available from
the Stop TB Initiative <http://www.stoptb.org/
Or contact Karen Reynolds [log in to unmask] The Stop TB Initiative, A
partnership hosted by WHO, Tel: +41 22 791 2653, Fax: +41 22 791 4199,
www.stoptb.org
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