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.