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UN: WHO Reports TB Control Progress Steady But Slow

The World Health Organization (WHO) says progress in tuberculosis control last year was steady, but slow, and experts are concerned that unless efforts are increased, the disease may soon overwhelm the world's poorer nations. Our correspondent K.P. Foley reports.

Washington, 21 March 2001 (RFE/RL) -- The World Health Organization says international progress at controlling the infectious disease tuberculosis, or TB, was steady last year but experts say more intensive efforts are needed to prevent the world's poorer nations from being overwhelmed by the contagion.

The WHO, a United Nations agency, released a new report 20 March on global TB control efforts. David Heymann, the executive director of the WHO's Communicable Diseases division, told reporters that millions of people are affected by TB.

"It's clear that each year more people are dying from tuberculosis. Last year we estimate that about two million people died and that 8.5 million people actually had active TB."

Tuberculosis is a communicable disease caused by bacteria. It can be spread through the air, but only people who are sick with active pulmonary TB are infectious. The germs are propelled into the air when an infected person coughs, sneezes, talks, or spits.

The WHO says that more than 250,000 cases of TB per year occur in Eastern Europe and the former Soviet Union. The TB problem is especially acute in prisons because of the continuous exposure in confined spaces.

Heymann blames the worldwide increase in TB on two causes.

"The reasons for the increases are mainly two different reasons. One is because TB is one of the major opportunistic infections in persons who are infected with HIV. And in fact up to 70 percent of people with TB in some countries are HIV-infected and have HIV-positive tests. So it's very important that we treat these two diseases together."

HIV, the acronym for Human Immune Deficiency Virus, is the infection that leads to the fatal condition known as AIDS. WHO experts have said that while the HIV-TB connection is increasing in Africa and Asia, it is not yet a serious problem in the former Soviet states and Eastern Europe. However, the resistance of TB bacteria to standard drug treatment is on the rise in the former Soviet region. Heymann says that is the second major factor in the TB increase.

"At the same time we're seeing an increase in resistance to the usual drugs to treat tuberculosis, and persons with multi-drug-resistant tuberculosis do have higher mortality rates, higher death rates."

The WHO says strains of drug-resistant TB have developed because of poorly supervised or incomplete treatment regimens. The agency says the spread of drug resistant TB threatens global TB control efforts.

However, the WHO says effective TB control regimes exist. WHO tuberculosis specialist Jacob Kumarason told the press briefing that proper TB control requires political will and a national commitment to follow a standardized UN treatment program called "DOTS." That stands for "directly observed treatment-short course."

DOTS is a treatment plan that requires a TB patient to take a combination of anti-TB medications each day for four to six months. The key to the success of the treatment, however, is observation of the daily doses by a qualified health professional. Too often, says the WHO, patients stop taking the drugs once they begin to feel better.

Kumarason says the DOTS treatment costs a total of about $10-$15 per patient.

At the same press conference, U.S. Congressman Sherrod Brown (D-Ohio) said he will introduce legislation in the House of Representatives to provide $200 million to an international campaign against TB. He said the goal is to raise $1 billion a year for ten years. Brown said the money could cut TB deaths in half.

(Statistics on individual countries available at