- The Washington Times - Monday, June 25, 2007

THE WASHINGTON TIMES

The World Health Organization has detailed a two-year plan to fight drug-resistant strains of tuberculosis — a move that comes in the wake of international concern over an Atlanta man suffering from such a strain who traveled overseas and risked infecting others.

The WHO plan, outlined Friday, calls for $2.15 billion over two years to prevent, detect and treat two forms of tuberculosis that are drug-resistant. The first type is known as multidrug resistant TB, or MDR, and the second type — which rejects even more drugs — is known as extensively drug-resistant TB, or XDR.

Last month, Atlanta lawyer Andrew Speaker traveled on two trans-Atlantic flights while infected with XDR-TB. He now is receiving treatment in a hospital in Denver.

WHO leaders said drug-resistant TB is a growing international problem and needs to be addressed quickly. They said that Mr. Speaker’s case “focused attention” on this need, but that health leaders already were concerned. Last year, the “virtually untreatable” XDR-TB claimed 52 lives in one region of South Africa.

“We have sounded the alarm on the potential for an untreatable XDR-TB epidemic,” said Dr. Mario Raviglione, director of WHO’s Stop TB department. “Today we issue our response on behalf of all patients and communities whose lives are at risk.”

The WHO’s drug-resistant TB plan — which prioritizes 25 of the hardest-hit countries, mainly in Africa, Eastern Europe and Asia — proposes to strengthen programs that treat drug-resistant TB, significantly increase laboratory capabilities so these strains can be more quickly diagnosed and fund research to find new preventive measures. The plan would coordinate closely with anti-HIV efforts because TB is a leading killer of HIV patients.

In fact, the 52 deaths in South Africa occurred in an area with a high prevalence of HIV, and Joanne Carter, a lobbyist with the grass-roots anti-poverty group Results, said that “was really a wake-up call to a lot of people who really care about AIDS and really care about Africa.”

Last week’s WHO plan — which updates last year’s broader, 10-year global plan to fight TB — would be carried out by WHO, the Stop TB Partnership and countries worldwide. The WHO estimates that it could increase by tenfold the number of drug-resistant TB cases that are diagnosed, treated and cured. If fully implemented, 124,000 lives would be saved over the next two years, according to the WHO, and health leaders would be on their way to providing diagnostics tests and drugs to all MDR-TB and XDR-TB patients by 2015, saving about 1.2 million lives.

Tuberculosis is a contagious illness that mainly attacks the lungs, claiming about 1.6 million lives a year. About 400,000 reported cases of TB a year now resist some or many drugs, and 37 countries have reported cases of XDR-TB, according to the WHO. Drug-resistant strains first develop when a TB patient doesn’t take his full dose of medicine or when a doctor treats normal TB incorrectly, health specialists explained.

U.S. lawmakers have taken some anti-TB action lately, too. Ms. Carter said it’s “a good sign” that House members last week added to one of their annual spending bills an extra $50 million for anti-TB efforts. Senators will begin discussing their version of that bill this week, she said. There’s also separate bills in both chambers to boost TB funding over the next few years.

Because of the TB-HIV link, the Bush administration also has stepped up its TB funding in recent years as part of the President’s Emergency Plan for AIDS Relief, U.S. Global AIDS Coordinator Mark Dybul told a House panel in April.