- The Washington Times - Wednesday, April 1, 2009

BEIJING (AP) - The Gates Foundation is funding tests of new treatments for tuberculosis patients in China, part of a critical worldwide effort to stanch emerging, hard-to-cure strains of the disease that the World Health Organization says are like a time bomb.

One of the world’s oldest and deadliest infectious diseases, TB has mutated into hardier forms that withstand some of the most commonly used medicines. Left unchecked, people with drug-resistant TB could spread the disease to others, creating a widespread epidemic in the highly mobile global economy.

At a meeting of health ministers in Beijing, software magnate Bill Gates’ foundation and the Chinese government announced a $33 million project that initially covers 20 million people in six provinces and will be expanded to 100 million people over five years.

New approaches being tried include tests that diagnose drug-resistant TB in hours instead of weeks and drug combinations that at least halve the number of pills patients have to take. Mobile phone text messages will be used to track patients and their treatments.

WHO Director-General Margaret Chan told health ministers and senior officials from 27 countries worst-affected by the new drug-resistant strains of TB that they must make dramatic improvements in detecting infections and build stronger health care systems.

“Call it what you may _ a time bomb or a powder keg,” Chan said at the opening of a three-day meeting on drug-resistant TB in Beijing. “Any way you look at it, this is a potentially explosive situation.”

Countries attending the meeting said Wednesday they would draw up national plans to provide drug-resistant TB patients with access to treatment by 2015, ensure a sufficient supply of anti-TB drugs, better train health workers and other measures aimed at controlling the spread of drug-resistant strains.

The disease is caused by germs that spread when a person with active TB coughs, sneezes or speaks. It’s ancient and treatable but now has evolved into stronger forms: multidrug-resistant TB, which does not respond to two top drugs, and extensively drug-resistant TB, which is virtually untreatable.

The problem has been partly blamed on health care systems that lose track of patients who do not complete their courses of treatment, allowing the TB bacteria to develop resistance to normally potent medicines.

In 2007, 1.75 million people died of tuberculosis. Of the more than 9 million people around the world who contract the disease every year, about 500,000 get multi-drug resistant TB. The WHO estimates that 150,000 people die of drug-resistant TB every year worldwide.

Nearly a quarter of those who contract the drug-resistant strains are in China, where legions of rural migrants face an inadequate health care system.

It is also a problem in India, where rural health care is often poor and there is little control over the sale of anti-TB drugs; Russia, which faces a shortage of qualified medical staff and drugs; and South Africa, where the disease thrives amid an AIDS epidemic that has weakened the immune systems of people with HIV.

The Bill & Melinda Gates Foundation chose to fund the TB project in China because the disease is such a large problem on the mainland and the foundation hopes any success in tackling it there will likely help push new approaches elsewhere.

“Because of its skill, its scale, its TB burden, its love of innovation, and its political commitment to public health, China is a perfect laboratory for large-scale testing of new tools and delivery techniques to fight TB,” Gates said at a news conference.

Medecins Sans Frontieres, also known as Doctors Without Borders, welcomed the Gates project but said China should not neglect other drug-resistant TB sufferers in the country who are not covered by the program.

“It’s a big pilot project but the question is what happens to all the other patients who need treatment now and what will be provided to them while this project is ongoing in the next five years,” said MSF’s Tido von Schoen-Angerer.

TB is usually treated in six months with a $20 cocktail of four antibiotics, but its drug-resistant form takes up to two years and is at least 100 times more expensive to fight.

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