More Financing Is Urged to Fight TB in Africa

Published: September 13, 2006

<nyt_text> </nyt_text>WASHINGTON, Sept. 12 ? The World Bank is spending far less on proven methods to combat tuberculosis in Africa, where almost 600,000 people die annually of the disease, than in India, China and Russia, according to a report released Tuesday by Results International, a nonprofit advocacy group.

Though a third of the world?s TB deaths occur in Africa, only about 5 percent of the bank?s zero-interest lending to fight the disease has gone to African countries over the past five years, the report said.

Tuberculosis can usually be cured with antibiotics that cost about $16, though recently a virulent strain resistant to standard treatment has flared in South Africa.

In a telephone news conference, the authors of the report brought in other advocates and public health experts to comment on their findings.

?The World Bank is simply not pulling its weight,? said Stephen Lewis of Canada, the United Nations special envoy for AIDS in Africa, who noted that tuberculosis killed more people with AIDS than did any other infection.

Richard Bumgarner, an economist who spent 29 years at the World Bank and developed and led its TB program in China in the early 1990?s, said, ?I was in disbelief and appalled when I read the report.?

Elizabeth Lule, a spokeswoman for the World Bank, said she welcomed the call for increased financing in countries with the highest prevalence of tuberculosis. ?We could have done much more, of course, than what we?re doing,? said Mrs. Lule, who manages the bank?s AIDS programs in Africa.
But she also said the bank?s managers for Africa had taken a different approach from those of teams working in India and China: in Africa, the bank has moved to strengthen public health care generally, rather than specifically attacking tuberculosis.

The bank, she said, is seeking to complement the work of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which is more directly involved in fighting TB.

?Giving African countries bank funding for each major disease would just increase the fragmentation of health care, financing and overall management of the health system,? she said in an e-mail message.