TB still a threat in Indonesia

TB still a threat in Indonesia

Muherman Harun, Contributor, mhjkt@attglobal.net

World TB Day on March 24 should be an important day for people
around the world to learn more about the global health threat
posed by tuberculosis (TB).

It will also be a day dedicated to recognize the collaborative
efforts of all countries involved in battling TB.

Although known as the white scourge of the middle ages, TB can
be cured, controlled and, with diligent effort and sufficient
resources, eventually eliminated.

In this country, TB is the third biggest killer after
cardiovascular disease and respiratory disease.

TB preys on people in their productive years (between the ages
of 18 and 60), especially those in the lower socioeconomic groups
(or "the poorest among the poor"). It is the number one cause of
avoidable death among women of child-bearing age.

TB affects each and every aspect of national life, hence
support for TB control programs must also come from every
quarter.

The Jakarta Partnership Forum to Combat TB in Indonesia was
formed based on the Amsterdam Declaration, which was signed in
2000 by the ministers of health of high-burden countries.

The objectives of the various partners involved is to assist
in Indonesia's tuberculosis control efforts by:
-- supporting the implementation of the five-year strategic plan
for 2002 to 2006;
-- building a strong coalition of professional
organizations/institutions, representatives from foreign
governments, bilateral and multilateral organizations,
international NGOs, private foundations and donor organizations;
-- improving coordination and communication between the partners
and between partners and the government.

What is needed today is a greater and intensive public
participation in the national campaign against TB. A vigorous
nation-wide campaign against this dreadful killer, involving all
medical doctors, specialists and other health personnel, needs to
be built around the World TB Day theme.

The message is simple: TB is curable. Everybody who has a
cough for three weeks must take a free sputum TB test. Directly
observed TB treatment should be regular and uninterrupted. Free
treatment should be available at all directly observed treatment
(DOTS) centers.

Under the theme Keeping the Pledge, the Partners' Forum of the
Stop TB Partnership will be the main event during the coming
World TB Day, to intensify efforts to reach the Stop TB targets
for 2005 and 2015.

The theme and supporting messages will leverage the positive
performance of the Stop TB Partnership and highlight the growing
pandemic of TB/HIV and other threats, in order to highlight the
need for renewed commitment to the pledge "now more than ever".

The forum, to be held from March 24 to March 26 in New Delhi,
India, will convene ministerial delegations from the 22 countries
with the highest tuberculosis burden, as well as high-level
political invitees from G-8 countries and all Stop TB partners.

World TB Day 2004 then will be a very powerful, high-profile
public health event, while worldwide various national TB events
are being organized.

The Global Plan and Partnership are working. The plan presents
a coherent strategy that has been effectively put into operation
by the partnership to achieve real progress with measurable
results, as shown by the numbers for DOTS expansion, the number
of treatments provided by the Global Drug Facility and the
improved treatment of MDR tuberculosis.

But the progress on TB could be reversed unless we shore up
national TB programs and invest in new approaches.

National TB programs and public health systems must be quickly
strengthened, and governments in endemic countries must increase
their political commitment and operational support to TB control
linked to poverty reduction. The continued rapid spread of the
TB/HIV joint epidemic could overwhelm control efforts in the next
few years in many countries, thereby putting gains at risk.

Greater investment is needed to accelerate both TB control and
the development of new tools. Without better tools, TB will
become more deadly and never be defeated. Only by developing new
drugs, diagnostics and vaccines can progress against TB be
rapidly accelerated and the disease eliminated as a global public
health problem.

Stopping TB is much more than just a medical challenge. It
requires concerted cooperation with a broadened range of partners
in the private and civil sectors -- businesses, religious groups,
NGOs and others -- to accelerate case detection of at least 70
percent of the infectious cases and a cure rate of at least 85
percent, as the Stop TB targets pledge before the end of the year
2005.