Desperate plea for TB drugs

By KATHERINE HOBY and REUTERS

New research - and cheaper drugs - are urgently needed to tackle tuberculosis, the deadly lung disease that kills over two million people globally every year, medical aid charity Medecins Sans Frontieres (MSF) says.

MSF said that even though a third of the population carried TB germs, or bacilli, the last innovative medicine was developed more than 30 years ago, while the last vaccine was made as far back as 1923.

"Despite these devastating statistics and a wealth of knowledge on TB, little research is being done into new medicines for the disease," said the organisation.

TB is a poverty-linked disease that usually affects the lungs and is spread by coughing, sneezing or spitting. Cases have risen alarmingly in Africa.

According to the World Health Organisation, which declared the epidemic a global emergency in 1993, eight million people become ill with TB every year. Three million of these are in Southeast Asia and a further 1.5 million in Africa.

TB is also on the rise in eastern Europe for the first time in 40 years.

Although one person is infected with TB every second, victims do not necessarily become ill. But the chance of becoming sick grows when the immune system is weakened, particularly by HIV.

MSF said the most effective way of treating TB was the directly observed treatment short course (Dots), which consists of direct supervision by a health worker of a patient's daily intake of multiple drugs over six to eight months.

This method is prohibitively expensive and beyond the means of many, MSF says.

"Dots is the only tool we have, but for the majority of TB patients who are poor to begin with, Dots isn't cheap and is not a simple treatment," said the MSF medical coordinator in Kenya, Pierre Mallet,

James Orbinski, the head of MSF's TB drug access initiative, said simpler and cheaper treatment was imperative.

FACT FILE

* TB is also known as consumption, wasting disease, and Pott's disease.

* It is spread by breathing in infected droplets exhaled by someone with TB.

* A person with TB may lose weight, feel tired, sweat a lot at night, and cough regularly for more than two weeks, often with thick phlegm, sometimes bloody.

* The most common site is the lung.

* Crowded living conditions and poor nutrition increase the risk.

* Treatment is a combination of antibiotics for at least six months.

* There are concerns about the increase in multidrug-resistant TB worldwide which is both difficult and expensive to treat. This is not a great concern in New Zealand.

* In 2000, there were 356 cases, 452 in 1999, 368 in 1998, and 330 in 1997.

* There were nine deaths from TB in New Zealand last year, 10 in 1999, eight in 1998, and 15 in 1997.

* Ongoing work to control TB includes: early case detection, education, provision of lab services, and appropriate screening of new immigrants.

* Source: Ministry of Health.