Southern States - Kerala

TB eradication a difficult task

By N. Gopal Raj

THIRUVANANTHAPURAM JUNE 4. As the 4th World Congress on Tuberculosis takes place in Washington, D.C., a report in a medical journal indicates that eradicating the disease could take far longer time than planned.

TB kills two million people worldwide each year. India has the largest number of tuberculosis cases in the world, with a third of global tuberculosis burden.

To bring TB under control, the World Health Organisation (WHO) had set the global target of detecting 70 per cent of all TB cases and successfully treating 85 per cent of those cases by the end of 2000, and this deadline was later extended to 2005.

WHO's Global Tuberculosis Control Report for this year, however, shows that the detection rate is only 27 per cent. Worse, the pace of detection had not speeded up. A paper published in the June issue of the WHO Bulletin, therefore, suggested that the goals for detection and successful treatment would be achieved only by 2013.

If that were not cause enough for gloom, Sally Blower of the University of California Los Angeles and C.L. Daley of the University of California San Francisco, argue that even 2013 may not be possible.

In their paper published in the latest issue of The Lancet Infectious Diseases, they point out that increasing the detection rate from the current 27 per cent to 70 per cent would require considerably greater effort than from zero to 27 per cent. A more realistic projection showed that it would take decades to achieve the detection rate of 70 per cent.

It was also highly unlikely that the treatment success rate of 85 per cent would be achieved by 2013, they say.

As the treatment coverage expanded from the "easy to find and treat'' patients to "difficult to find and treat'' ones, treatment success rates could fall. Drug-resistant and multi-drug resistant TB complicated matters.

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