WHO: Drug resistant tuberculosis levels ten times = higher in Eastern Europe and Central Asia

From: Subject: WHO: Drug resistant tuberculosis levels ten times higher in Eastern Europe and Central Asia Date: Sun, 21 Mar 2004 18:44:56 +0200 MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_000_0000_01C40F74.9B17FCC0"; type="text/html" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2800.1165 This is a multi-part message in MIME format. ------=_NextPart_000_0000_01C40F74.9B17FCC0 Content-Type: text/html; charset="utf-8" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.who.int/mediacentre/releases/2004/pr17/en/ =EF=BB=BF WHO: Drug resistant tuberculosis levels ten times = higher in Eastern Europe and Central Asia

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Drug resistant tuberculosis levels ten times higher in = Eastern=20 Europe and Central Asia

16 MARCH 2004 | GENEVA -- = Tuberculosis patients in parts of Eastern Europe and = Central=20 Asia are 10 times more likely to have multidrug-resistant TB = (MDR-TB) than in the rest of the world, according to a World = Health=20 Organization (WHO) report into the deadly infectious = disease. China,=20 Ecuador, Israel and South Africa are also identified as key=20 areas.

New data released today confirm geographical = concentrations of TB drug resistance across the Commonwealth = of=20 Independent States. Six out of the top ten global hotspots = are:=20 Estonia, Kazakhstan, Latvia, Lithuania, parts of the Russian = Federation and Uzbekistan, with drug resistance in new = patients as=20 high as 14%.

"TB drug resistance is an urgent public = health issue=20 for countries from the former Soviet Union," said Dr Mario=20 Raviglione, Director of WHO's Stop TB Department. "It is in = the=20 interest of every country to support rapid scale-up of TB = control if=20 we are to overcome MDR-TB. Passport control will not halt = drug=20 resistance; investment in global TB prevention will."



	Related links Anti-Tuberculosis Drug Resistance in the = World Tuberculosis

WHO's leading infectious disease experts = estimate=20 there are 300 000 new cases per year of MDR-TB worldwide. = There is=20 also new evidence proving drug resistant strains are = becoming more=20 resistant, and unresponsive to current treatments. 79% of = MDR-TB=20 cases are now "super strains", resistant to at least three = of the=20 four main drugs used to cure TB.

MDR-TB is TB that is resistant to the two = medicines=20 most commonly used to treat it, Isoniazid and Rifampicin. = Without=20 the correct drugs MDR-TB is untreatable and in most cases = fatal.=20 Though curing 'normal' TB is cheap and effective - a six = month=20 course of medicines costs US$ 10 - treating drug resistant = TB is a=20 hundred times more expensive. Even then a cure is not = guaranteed.=20 With no effective vaccine, everyone is vulnerable to = infection=20 simply by breathing in a droplet carrying a virulent drug = resistant=20 strain.

Highest prevalence of MDR-TB coincides with = one of the=20 world's fastest growing HIV infection rates in Eastern = Europe and=20 Central Asia. Recently the United Nations Development = Programme=20 reported more than 1.5 million people living with the virus = in the=20 region, compared to just 30 000 in 1995. People whose immune = systems=20 are compromised with HIV are many times more susceptible to=20 contracting all forms of TB.

"With people's immune systems compromised, = MDR-TB has=20 a perfect opportunity to spread rapidly and kill," said WHO=20 Assistant Director-General of HIV/AIDS, TB and Malaria, Dr = Jack=20 Chow. "As a priority to prevent the spread of all forms of = TB, we=20 need more investment in resources, programmes and health=20 workers."

New surveys in China, where HIV is also = increasing,=20 have also mapped MDR-TB areas of concern. Two provinces = revealed=20 around one in every ten new patients tested positive with = MDR-TB.=20 The report's authors fear similar high levels of resistance = could=20 exist elsewhere, since only six of the country's 23 = provinces were=20 represented in the study.

Some successes have been achieved since the = last study=20 four years ago - most notably in Cuba, Hong Kong and the = United=20 States. Rates in those countries have decreased, as a result = of=20 strong and well-maintained TB strategies.

According to the report "the most effective = strategy=20 to prevent the emergence of drug resistance is through=20 implementation of the DOTS." DOTS is the internationally = agreed=20 treatment strategy, and is designed to ensure patients take = their=20 medicines properly. It has proven effective in preventing = drug=20 resistance.

The report also notes TB control strategies = used in=20 Eastern Europe and the Russian Federation have recently = begun to=20 improve with the introduction of the DOTS strategy. In worst = affected areas innovative "DOTS Plus" schemes which diagnose = and=20 treat effectively drug resistant TB, are being introduced. = Patient=20 access to MDR-TB drugs is key to the success of the DOTS = Plus=20 strategy. The cost of supplying these medicines has fallen=20 dramatically through initiatives backed by the WHO, namely = the Green=20 Light Committee, which engages pharmaceutical companies to = fully=20 support the fight to eradicate drug resistant TB.

Research and development into new TB drugs = is also=20 urgently required to shorten the length of treatment and to = treat=20 drug resistant strains. After a 40 year standstill in TB = drug=20 development, R&D investments are critical now to expand=20 treatment options and overcome resistant strains. The Global = Alliance for TB Drug Development, a WHO partner, is building = a=20 pipeline of promising new drugs and uniting public and = private=20 researchers in the search for a faster cure.

"Anti-Tuberculosis Drug Resistance in the = World -=20 Third Global Report" presents data from the examination = of 67=20 657 TB patients in 77 countries and regions.

"The more we survey, the more MDR-TB we = find," said=20 the report's leading author Dr Mohamed Aziz. "MDR TB has now = been=20 identified in every region and almost every country surveyed = in what=20 is the largest drug resistance surveillance project of its = kind. Yet=20 the true burden is unknown and may well be higher in = unsurveyed=20 areas, stressing the need for full expansion of drug = resistance=20 surveillance."

3D"horizontal

Editors Note: On 24 March, WHO will = release its=20 2004 Global TB Control Report in tandem with the opening of = the 2nd=20 Stop TB Partners' Forum in New Delhi, where donors, = technical=20 agencies and ministers from the 22 High TB Burden Countries = will=20 discuss accelerated action to expand DOTS and contain the = global=20 epidemic.

For more information=20 contact:

Thomas Schoenemann
Berlin =
Mobile phone:=20 +49 (173) 65 05 735=20

Jove Oliver
Kiev
Mobile phone: = +380 (505)=20 948 616=20

Glenn Thomas - Communication Officer =
Stop TB=20 Department
WHO, Geneva
Telephone: +41 22 791 3983 =
Mobile=20 phone: +41 79 509 0677
Email: thomasg@who.int=20

Gwynne Oosterbaan
New York =
Mobile phone:=20 +1 (646) 258 8410=20

Patrick Bertrand
Paris/Brussels =
Mobile=20 phone: +33 6600 40442=20

Nicole Janssen
The Hague =
Telephone: +31=20 (70) 416 7220
Mobile phone: +31 (6) 3800 2009=20

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