TB not getting the attention it deserves

By Iana Seales In Vienna, Austria

Tuberculosis is the forgotten disease says Peg Willingham, Senior Director for External Affairs at Aeras Global and she also points out that funding is not enough at the global level to effectively tackle the illness in many countries.

Peg Willingham

Willingham was speaking at one of a series of events preceding yesterday’s start of an international gathering of some 20,000 AIDS activists, scientists and HIV patients in Vienna, Austria.

Multi-drug Resistance (MDR) TB is particularly serious in developing countries, Willingham said on Thursday at a health workshop, noting that poverty continues to create greater problems in the fight against TB. She emphasised that funding needs to be scaled up if tuberculosis is to be effectively treated.

Willingham told reporters that HIV/AIDS has attracted the bulk of funding within the past decade while TB has been largely forgotten and she underscored that TB is the leading cause of death in AIDS patients, and that it remains a major issue due to climbing co-infection rates. She called MDR a “public health time bomb” which is creating major problems in the fight.

She said one person with active TB will infect about 15 people a year if they are not treated, adding that in many countries this is exactly what happens. TB patients, she said, often drop out of the six-month long treatment programme and end up ill for longer periods in addition to posing a risk to the general population.

The problem is the length of the treatment period, she noted. Willingham said her company, an NGO, is part of the Global Alliance for TB drug development. Willingham said that they are working along with pharmaceutical companies to develop a new TB drug because “one has been long overdue”. Pointing to “the reality”, she noted that within the past 30 years close to 25 new drugs were developed for HIV/AIDS while no new drug has been developed for TB within that period. In fact, she said the current TB treatment has been around since 1921.

Willingham said the focus is on developing a drug which will reduce the treatment period to four months and according to her, this new drug could be another few years away. “2020 is our best hope for a new vaccine, it doesn’t seem possible before then”, she added. Work is currently being conducted in several countries where TB prevalence is high, she noted, citing some countries in Africa.

Africa is being targeted because of the prevalence, she continued, saying that the continent has a prevalence rate in some countries of around 900 per 100,000 persons. Willingham indicated that the prevalence rate in other countries like the United States points to around 5 per 100,000 persons. “The disparity is great”, she noted, reiterating that poverty among other issues is fuelling the problem in the developing world.

Of the TB cases in the US, she said, around 60 percent are diagnosed in people who were born outside the US. She said this poses serious challenges because many of those infected are afraid to come forward for treatment since they are part of the immigrant community. Further, she said that current anti-immigrant sentiments in the country are not helping the problem in the US.

Willingham said too that the profile of TB has to be raised in many countries since according to her, not enough information is out there about the illness. She stated that comparatively, HIV/AIDS awareness is tremendous in many nations but that the information on TB is seriously lacking. “Adequate information is not out there about TB and people are not usually advised to take TB tests…maybe we can start moving in that direction though some challenges would be obvious”. She said it would be a huge challenge to test everyone in a country for TB.

Questioned on the most effective strategy used to treat TB patients outside of administering the treatment, she said that quarantining patients for the first three weeks is advised because they are still contagious. However, after that period if they are complying with treatment she said patients should be allowed to move around freely.  “It’s a situation where we weigh the patients’ rights versus society’s rights”, she added.

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