WHO sounds alarm over TB, HIV plague in Asia

WHO sounds alarm over TB, HIV plague in Asia

BANGKOK (Reuters): The World Health Organization is worried a
fatal combination of tuberculosis and HIV could create a public
health disaster in Asia if governments cut back medical programs
because of the regional economic crisis.

Eight million people are infected with tuberculosis worldwide
every year -- two thirds of them in Asia -- and three million
die, Kraig Klaudt, head of the policy, strategy and promotion
unit of the WHO's global TB program, told Reuters in an
interview.

This was despite the existence of highly effective treatments
to cure and prevent the disease, said Klaudt, who spoke ahead of
a WHO-sponsored conference on tuberculosis in Bangkok on Monday.

"TB is the leading killer of youth and adults in the world and
it's all the more tragic that unlike AIDS, where we are still
developing interventions, there is an effective intervention for
TB. All these deaths should be prevented."

He said 50 percent of all people in Asia were infected with
tuberculosis, but in the vast majority of cases it remained
dormant, unless awakened by infections like HIV.

Klaudt said the WHO was alarmed HIV was helping to "fast
forward" the emergence of usually fatal multi-drug resistant
tuberculosis in the region.

In some Asian countries there were now "incredibly high"
prevalence of tuberculosis and HIV and multi-drug resistant
tuberculosis, he said.

"When you had these factors converging in New York City in the
early 1990s, you had a huge public health disaster. The rate of
drug resistance was incredibly high -- 20 percent...it was
virtually a death sentence for those patients."

He said treating drug resistant tuberculosis was nearly 100
times as expensive as treating a normal case -- in New York
reaching $250,000 per patient per year.

"Then, in most instances, it could not be cured -- it was
fatal," he said.

The WHO, which declared tuberculosis a global health emergency
in 1993, is urging governments to implement a strategy called
"DOTS" -- or Directly Observed Treatment Short-course strategy to
combat the disease.

The medicines employed in the course are virtually 100 percent
effective in curing the disease, Klaudt said.

However, the WHO was concerned the implementation of the
programs was not happening fast enough and with the economic
crisis in Asia, there was a danger progress in recent years could
be lost, Klaudt said.

"There is good reason for all countries that are suffering
from the economic crisis not to sacrifice their public health
systems as the consequences really are quite severe.

"Asia has to have the same concerns, should study what
happened in the former Soviet Union and the Eastern European
states when you had an economic collapse.

"You basically saw public health services crumble...and you
saw a just startling return of diseases that were well under
control. In Russia TB increased by 70 percent in just a few years
time and drug resistance is a now huge problem there."