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Back To Vidyya WHO And Stop TB Launch New Initiative To Increase Access To Free TB Drugs:

The Global TB Drug Facility

The World Health Organization (WHO) and the global partnership to Stop TB today announced a new initiative to increase access to tuberculosis (TB) drugs for ten million patients over the next five years. The Global TB Drug Facility, which is housed by WHO and managed by the Stop TB partnership, aims to significantly increase access to high quality TB drugs. WHO called for a commitment of at least US$50 million per year for the next five years to the Global TB Drug Facility.

The Global TB Drug Facility will be launched in Washington DC this afternoon, and will finance procurement of quality TB drugs for countries with a high burden of TB. The aim of the Global TB Drug Facility is to provide TB drugs for ten million patients over the next five years and 45 million patients over a 10-year period.

With an initial contribution from the Canadian International Development Agency, the Global TB Drug Facility recently approved grants to several countries in Africa, Asia and Eastern Europe to treat nearly 200,000 patients. A second round of applications will be processed by July 2001, enabling the Global TB Drug Facility to provide drugs for nearly half a million TB patients in its first year of operations.

Although developing countries, which together account for over 90% of the global TB burden, are the main target for the Global TB Drug Facility, industrialized countries will indirectly benefit from the support it provides. As the global population becomes more mobile, there is abundant evidence that national borders are no obstacle to the spread of TB. Outbreaks of infection acquired during air travel are a growing hazard, and most worryingly, several of these have resulted from Multi Drug Resistant TB – a form of TB that is expensive and difficult to cure. Hot spots of MDR TB have been found in many countries, particularly in countries of the former Soviet Union. Controlling TB in any single country means controlling TB globally. Investing in the Global TB Drug Facility is not just a humanitarian responsibility for developed nations – it makes good public health sense.

"Access to treatment and care is basic to human rights," said Dr Gro Harlem Brundtland, Director-General of the World Health Organisation. "When access is neglected or denied, health and human rights suffer. We all know that poor people suffer most of infectious diseases, and TB provides one of the clearest examples. It is shameful that many TB patients are still dying of the disease, and inexcusable that less than a quarter of them have access to effective TB treatment", she added.

The theme for World TB Day, which is commemorated each year on 24 March, the anniversary of the discovery of the germ that causes TB, is "DOTS: TB cure for all", highlighting the importance of ensuring access to treatment for all people with TB; whether rich or poor, young or old, male or female, irrespective of race, ethnicity, social status, or the many other means by which people in need are deprived of treatment that should be theirs. It draws attention to those TB patients who have special needs, such as people with HIV and those with drug resistant TB.

TB is the world’s leading curable infectious killer. Every day 20,000 people develop active TB, and 5,000 die from their disease. Without treatment, about 70% of people with TB will die, and untreated, a single person with infectious TB can infect between 10-15 people a year. The global TB epidemic increased 6% between 1997 and 1999, largely due to a 20% increase in African countries affected by the HIV/AIDS epidemic. If these trends continue, some 10.2 million new cases are expected each year by 2005.

The continued growth of this epidemic is totally unnecessary and completely avoidable. DOTS – the WHO approved strategy for TB control, cures patients, saves lives, prevents the spread of drug resistance, and reduces transmission of the disease. The social and economic benefits are equally profound. Yet progress in expanding DOTS remains totally inadequate. In a report published this week, WHO announced that only 23% of people with infectious TB were treated in DOTS programmes. Unless there is a rapid acceleration of DOTS expansion, global targets to detect 70% of people with infectious TB, and cure 85% of those detected will not be met until 2013 by the earliest.

A significant barrier to rapid DOTS expansion is drug shortages. A 6-8 month course of treatment for TB costs as little as US$ 10. Still, shortages of TB drugs are frequent and serious, often caused by financial constraints, inefficient drug procurement systems, and poor management. The drugs used to treat TB have been available for over three decades, yet millions of patients still do not have access to effective treatment.

"Future generations will no doubt ask us why we continued to allow two million people to die every year from a disease that can be cured with drugs that cost only $10-15. They will rightly question our commitment, our priorities, our sense of justice, and our understanding of human rights", said Dr JW Lee, Director of the WHO department to Stop TB.

A year ago on World TB Day, Ministers of Health, Finance and Planning from 20 of the highest TB burden countries in the world met in Amsterdam for a conference on TB and Sustainable Development. They set ambitious objectives to mobilize political commitment and to reach the global targets by 2005, to prevent further spread of TB and multi-drug resistant TB, and called on the international community for assistance. The Amsterdam Declaration to Stop TB called for "new international approaches towards ensuring universal access to, and distribution of tuberculosis drugs." The Global TB Drug Facility has been established by WHO and the global partnership to Stop TB as a direct result of that call.

"We have to bring in more funding to take quality drugs to the people that need them most. I am urging you on behalf of the young and the old, the impoverished and the imprisoned, to join us in efforts to Stop TB. Your involvement will move us closer to our aim of a world where no one will be denied access to DOTS" Dr Brundtland concluded.

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Editor: Susan K. Boyer, RN
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