Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
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Wall Street Journal - July 16, 2003
Gautam Naik, Staff Reporter of The Wall Street Journal
In a report released during a big AIDS conference Tuesday in Paris, the World Health Organization said that although a typical TB treatment costs as little as Ç8.86 ($9.89) a person, many governments haven't made the drugs available to patients. Such neglect contributes to eight million new TB cases each year, and two million deaths, according to the report.
There is a deadly link between HIV and TB. By weakening the immune system, the AIDS virus makes a person more susceptible to tuberculosis. About one-third of the 42 million people living with HIV/AIDS are also infected with TB, according to the WHO report. Some 90% of HIV patients die within two-to-four months of becoming sick with TB if they don't receive proper treatment.
The runaway rates of TB -- fueled by the rise of HIV co-infections -- could undermine the WHO's desire to reduce the prevalence of the disease.
The agency has set global targets to detect, by 2005, at least 70% of the world's infectious TB cases and cure at least 85% of those cases.
Currently, only one-third of cases are detected, while cure rates are approaching desired levels. A related and more ambitious goal is to reduce TB prevalence and mortality by half by the end of the decade.
"There is a risk that we will not achieve this target," acknowledged Mario Raviglione, acting director of the WHO's Stop TB department. "Governments don't commit enough resources and external donors forget about TB," because it is often considered a disease of the past, he said in an interview. Countries that need to strengthen their approach include China, Indonesia and Nigeria, he added.
The WHO also has been pushing countries to adopt its guidelines for TB treatment, known as Directly Observed Treatment, Short-Course, or DOTS.
The guidelines include recommendations for diagnosis, medication and keeping track of cases. Currently, only one-third of all tuberculosis patients are treated in ways that conform to the guidelines.
The region hardest hit by the deadly interaction between HIV and TB is sub-Saharan Africa, where HIV is triggering a 6% rise in the annual number of tuberculosis cases.
Write to Gautam Naik at gautam.naik@wsj.com
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