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WHO Moves To Bring Fast Treatment For Drug-Resistant TB

Nine million new cases of tuberculosis are reported each year
WASHINGTON -- The UN's World Health Organization has announced a new, two-pronged initiative to bring faster diagnoses and proper drug treatment to people suffering from multidrug-resistant tuberculosis (MDR-TB) in countries that have few resources to deal with the disease.

MDR-TB is a rapidly spreading disease. The WHO says about 450,000 of the 9 million new cases reported each year are resistant to medications that are capable of treating nonresistant instances of the disease, known as "front-line" drugs.

What's made MDR-TB even more difficult to control is that, until now, diagnosis has taken months, according to Karin Weyer, the team leader for laboratory strengthening at the WHO's Stop TB Department in Geneva.

"The main problem has been the long delay in making a laboratory diagnosis," Weyer says. "This means that the diagnosis is always late by two or three months, and many times it takes even longer. And especially when those patients are also HIV-infected, what in reality has happened up to now is that patients have died even before the diagnosis could be confirmed."

And, Weyer adds, during this time they can spread the disease, as well. Tuberculosis is easily spread through the atmosphere by coughing or even talking.

Fast And Inexpensive

The diagnostic test, however, takes no more than two days and is inexpensive, costing only about $8. A sample of a patient's sputum is scanned to determine whether it contains DNA indicating a resistance to "front-line" tuberculosis drugs.

But the test is only the first half of the new WHO program.

"The first project is introduction into developing countries of a rapid, new, DNA-based test to diagnose MDR-TB directly on the sputum specimens within one to two days," Weyer says. "The second part of the project has been to make sure that there are adequate drugs available to treat MDR-TB patients with. So [the program] links diagnostics with treatment very nicely."

The new program is made possible by two grants from UNITAID, a facility of the UN started by Brazil, Britain, Chile, France, and Norway to help finance the organization's public health initiatives.

Weyer says UNITAID may be unique in how it generates money to address public health issues.

"It's a very novel funding initiative driven by a number of countries," she says. "It started off as a tax on airline tickets initiated by five countries, and it's now grown into much more. More than 20 countries are now contributing to UNITAID."

UNITAID is providing $26.1 million to the diagnostic effort and $33.7 to provide the drugs needed to treat MDR-TB in countries where the disease is a growing problem and resources are slight.

Problems In Russia, Eastern Europe

Weyer says MDR-TB isn't merely a problem in Third World countries of Africa and Asia.

"Definitely, Russia and Eastern European countries have a problem with tuberculosis, also with multidrug-resistant tuberculosis, as do countries in Southeast Asia and Africa," Weyer says. "So this project is aimed at moving the new diagnostics and the drugs into16 of the 27 high-priority countries for MDR-TB."

At a news conference in Geneva to announce the two-step MDR-TB initiative, WHO officials say they expect it will produce significant results not only in diagnosing and treating TB patients, but also in driving down the costs of treatment.