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Killer, Drug-Beating TB Needs $650 Million War Chest, WHO Says

Sally Furniss

Well-known member
Killer, Drug-Beating TB Needs $650 Million War Chest, WHO Says

http://www.bloomberg.com/apps/news?pid=20601202&sid=a1x4QMsSa_x4&refer=healthcare

By John Lauerman

Feb. 25 (Bloomberg) -- Health officials need almost a half-billion dollars more this year to fight tuberculosis than in 2006 because of the emergence of a new form of drug-resistant TB that kills two-thirds of people infected.

Countries with small health budgets need at least $604 million to expand testing and treatment for XDR-TB, a drug- beating strain spreading in Africa and Europe, said Paul Nunn, head of the World Health Organization's Stop TB department. The WHO and other TB-control groups need another $42 million to coordinate efforts worldwide, he said.

Last year, the agency requested only $200 million to fight drug-resistant forms of the disease. TB can mutate to overcome the effects of multiple treatments, and the XDR-TB strains threaten to become the driving force in a worldwide TB epidemic, Nunn said today at a medical meeting in Los Angeles.

``Unless we strengthen our control measures to make sure we're identifying and managing extensively drug resistant cases, we'll see them spread and multiply into something much worse than we started off with,'' Nunn said. The money is needed to avert ``a human catastrophe,'' he said.

Caring for strains of TB that are susceptible to doctors' preferred treatments normally costs about $200 per case, Nunn said. Treating resistant strains such as XDR-TB requires drugs such as Eli Lilly & Co.'s Capastat and can cost more than $4,000 per case, he said.New drugs that might be effective against XDR- TB are at least five years away from testing, Nunn said.

The WHO and partner organizations such as the International Union Against Tuberculosis and Lung Diseases get much of their funding to battle diseases from groups such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, and governments of wealthy countries, Nunn said.

Driving Force

Nunn's comments came during an interview at the 14th annual Conference on Retroviruses and Opportunistic Infections that began today. While patients with HIV, which impairs the body's defenses, are at particularly high risk, the drug-beating strains threaten to become the driving force in a worldwide tuberculosis epidemic, Nunn said.

The number of countries with XDR-TB cases has risen to 28 from 17 in March, 2006, including cases recently identified in Italy, the WHO said in a statement. The disease is a risk to patients with and without HIV, and to the health workers who care for them, Nunn said.

In areas where XDR-TB is already spreading, HIV patient groups are at particular risk, Nunn said. A deadly outbreak of the disease in South Africa's KwaZulu-Natal region began spreading among patients in a literacy program for HIV patients, he said.

``This is something that the HIV community needs to be aware of,'' he said.

HIV-TB Link

XDR-TB remains a significant problem in South Africa that has been exacerbated by the country's management of its HIV epidemic, said Karin Weyer, head of TB for the South African Medical Research Council, a medical scientific organization that receives government and private funds.

There were an estimated 650 XDR-TB cases in South Africa last year, 330 of them confirmed, and all nine provinces were affected. There were 106 cases of XDR TB confimed last year in an outbreak in Tugela Ferry, the focus of the KwaZulu-Natal outbreak in South Africa, Weyer said.

The vast majority of XDR-TB infections occur in people whose immune systems are damaged by HIV, and about 84 percent of those patients died. About one-third of South African health- care workers are thought to be HIV-infected, she said in a news conference at the meeting.

``This raises difficult issues for HIV testing for health care workers in this environment,'' said Kevin de Cock, director of the WHO's HIV/AIDS program, in the news conference.

To contact the reporter on this story: John Lauerman in Boston at jlauerman@bloomberg.net .
Last Updated: February 25, 2007 19:53 EST
 
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