World TB day - raising awareness about a major public health challenge
Holzkirchen, Germany, March 22, 2013
It is 1882, and tuberculosis (TB), is raging throughout Europe and the Americas, causing the death of one in every seven people. On 24 March, the German scientist and physician Robert Koch astounded the world by announcing that he had found the cause of the tuberculosis infection, the TB bacillus. This discovery opened the way towards diagnosing and curing TB. In 1905 he was awarded the Nobel Prize for his work on TB.
In his honour, the World Health Organisation and its partners designated March 24 as World TB Day and have continued to mark the day for the last 13 years. World TB day serves to raise awareness about a major public health challenge that still causes the deaths of over 1.0 million people every year, mostly in developing countries.
A global scourge that can be overcome
TB is caused by bacteria Mycobacterium tuberculosis1. It is contagious and spreads through air. If someone with TB coughs, sneezes or spits, the TB bacilli spreads in the air and can infect healthy people. One untreated TB patient can infect 10-15 healthy people a year1.
Those most vulnerable to TB infection often live below the poverty line, in crowded housing and are unaware of the seriousness of TB. Overburdened healthcare facilities also make identifying those people susceptible to infection difficult.
Common symptoms of TB are coughs that last more than two weeks with or without fever, a loss of weight and loss of appetite. TB can be diagnosed with sputum microscopy and chest X-rays2. However TB attracts lot of social stigma which delays the TB diagnosis. It has been observed by health professionals that majority of the TB cases are in their productive age (from 15-49 Years) 1 and often affects bread winner of the family. Thus in addition to patient’ suffering it also adds to the misery to the lives of family members.
But the good news is that TB is preventable and curable and the global rate of infection is decreasing. This is because TB is treated with selective anti-bacterial drugs over a period of 6-8 months. It is essential that patients complete the course. About 51 million TB patients, worldwide, have been successfully treated since 1995.
Despite the progress, each year around nine million new cases of TB are identified, with around 80% of cases in South East Asian and African countries. India and China account for almost 40% of the world’s TB cases1.
Major obstacles to effective treatment include the social stigma attached to the disease, delaying diagnosis, as well as patients not completing the course of treatment which can lead to them developing more severe forms of the disease such as Multidrug resistant TB (MDR TB) and Extremely Drug Resistant TB (XDR TB).
WHO fights tuberculosis:
The World Health Organization (WHO) fights TB globally through STOP TB Partnership along with various stakeholders. STOP TB partnership designed a blue print for TB Control through Global Plan to STOP TB 2006-153. The plan strongly recommends use of time-tested Directly Observed Treatment Strategy (DOTS) to reduce the global burden of tuberculosis. DOTS Strategy emphasizes the necessity of early diagnosis through quality-assured bacteriology and providing standardized treatment under supervision5. Observed treatment maximizes the treatment adherence and minimizes the recurrence of TB. It is important to note here that anti-TB drugs currently in use were discovered about 4 decades back and since that time no effective new TB drugs have been available. Thus, these anti-TB drugs should be used as per the recommendation of the health professionals. More severe form of TB like Multidrug resistant TB (MDR TB) and Extremely Drug Resistant TB (XDR TB) has emerged due to irrational use of the TB drugs and non-compliance to treatment and quality of TB drugs4.
Management of MDR TB and XDR TB has multiple issues, such as inadequate diagnostic facilities, extended treatment of 18-24 months with 5- 6 oral and injectable drugs, potential side effects, and treatment is very expensive5.
Sandoz - partner in Global TB Control
Sandoz is pursuing a diverse anti TB strategy, which includes providing high quality, effective and affordable TB medication.
Sandoz is pre-qualified by the WHO to supply fixed dose combinations (FDCs) of anti- TB drugs to Global Drug Facility (GDF) of the WHO.
Join in the fight
Join the fight against TB this World TB Day by helping to raise awareness of the disease. The StopTB website is supported by the WHO, and contains lots of useful information and opportunities to spread the word through social media channels including Twitter, Facebook and YouTube. To find out more about what Sandoz is doing in the fight against TB, visit tbdots.com, Sandoz’s global TB initiative website.
By Tejasvi Sharma
The author is General Manager, Global TB & API Business, Sandoz Pvt. Ltd. India
1Global Tuberculosis Control: WHO Report 2012
2TUBERCULOSIS MDR-TB & XDR-TB 2011 PROGRESS REPORT, WHO Publication
3Global Plan to STOP TB 2006-2015, WHO Publication 2006
4TUBERCULOSIS MDR-TB & XDR-TB 2011 PROGRESS REPORT, WHO Publication
5The programmatic management of drug-resistant tuberculosis 2011 update, WHO Publication 2011