E-drug: Tuberculosis: WHO Supports New, More Expensive Strategy
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Here is a report about Multiple Drug resistant Tuberculosis. As soon as I
discover where the report is available, I will inform E-Druggers. As I have
mentioned before I think that this epidemic could be more serious that the
AIDS epidemic. What I don't understand is why the drugs used to treat
MDR-TB are so expensive. They are off patent and can be produced in
different countries. Is this just a case of low levels of demand?
The New York Times has an interesting article about the report. The URL for
the article is
http://www.nytimes.com/library/national/science/health/102899hth-tuberculosi
Richard Laing
Associate Professor of International Health
Boston University School of Public Health
715 Albany St, T4W, Boston MA 02118 USA
Tel 617 414-1444 Fax 617 638-4476
E-mail richardl@bu.edu
Tuberculosis: WHO Supports New, More Expensive Strategy
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Source: http://www.unfoundation.org/unwire/unwire.cfm#ad
International health officials and scientific experts say that new
multidrug-resistant strains of tuberculosis require a new strategy to
prevent the epidemic from "spinning out of control".
Doctors from Harvard Medical School and the Open Society Institute, a
foundation financed by philanthropist George Soros, said more intensive
treatment against highly resistant strains of TB is needed in
the former Soviet Union and other regions where the rates of the resistant
strains are high. While the World Health Organization currently recommends
that TB patients take up to four drugs daily for
six to eight months, the new plan would require patients to take many
additional expensive drugs over a longer period of time.
The WHO supports the idea, and its Director-General, Gro Harlem>Brundtland,
is expected to be present when the 408-page report is released today in New
York. "This is a landmark shift by the WHO, the most exciting step forward
in the global effort to control TB in 25 years," said Michael Iseman,
director of TB services at a Denver research center.
Some strains of TB have proven resistant to the WHO's Directly Ob-served
Therapy Short-Course (DOTS). "In our zeal to implement DOTS everywhere,
there was no clear policy in the program to take care of
multidrug-resistant TB," said Dr. Mario Raviglione, the WHO's coordinator
for bacterial and viral diseases. "Now we realize that something more must
be done." Under the new strategy, called DOTS Plus, doctors will observe
patients take as many as seven drugs daily for up to two years, "at a far
greater cost per cure."
Cost Of Treatment Ignites Controversy
Some experts fear that DOTS Plus will shift resources away from patients
with TB that is not drug-resistant. "The WHO declared TB a
global emergency in 1993," said Dr. Thomas Frieden, a WHO officer in
Southeast Asia. "But six years later, fewer than 20% of patients get
even basic treatment." He added that anti-TB efforts should focus on
its cause -- inadequate treatment of ordinary tuberculosis.
While Raviglione said he did not know how much DOTS Plus would cost,
he conceded that the expanded strategy would almost certainly cost
hundreds of millions of dollars, "perhaps $1 billion more" than the
current treatment, which many doctors complain is underfinanced. He
added that its adoption would not mean abandoning the existing DOTS
strategy.
Some doctors fear there will be a contest for resources in treating
drug-resistant and non-drug-resistant TB. But Dr. Lee Reichman, executive
director of the National Tuberculosis Center in Newark, New Jersey, said,
"I'm on the WHO's TB working group, and we've made it clear that won't
happen."
The Harvard and Open Society Institute study predicts 171 million new TB
cases worldwide even if the DOTS Plus strategy is implemented. It projects
60 million deaths from TB by 2030. A worst-case prediction puts the figure
at 249 million new cases and 90 million deaths.
(Judith Miller, New York Times, 28 Oct)
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