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The BBC's Richard Hannaford
"It's not a local issue but a global one"
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Prof Gary French, St Thomas' hospital, London
"Need to educate people"
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Friday, 24 March, 2000, 06:10 GMT
Global threat of TB
Tuberculosis
TB is becoming resistant to drugs
Tuberculosis threatens to become a major health menace throughout the world, experts have warned.

Marking World TB Day on Friday, the United Nations Children (Unicef) warned that the deadly disease is "one of the most seriously neglected and underestimated health, human rights and poverty problems of our era".

TB already accounts for two million deaths a year worldwide, and strains of the bug are becoming increasingly resistant to antibiotics.



We face a rise in the incidence of multi-drug resistant TB. That would be a humanitarian and epidemiological disaster

Andre Roberfoid, deputy executive director, UNICEF
Experts fear that the disease will begin to spread even more rapidly as improved transport systems make travel increasingly easy.

A conference of international experts in Amsterdam is expected to announce on Friday an ambitious strategy to combat drug resistance in the worst affected countries.

The main focus of these efforts will be tripling of access over the next five years to an intensive six-month course of treatment proven to prevent drug resistant TB from developing.


Increasing drug resistance of tuberculosis
Resistance to at least one TB drug up 50% in Germany and Denmark, and 100% in New Zealand since 1996
Over 3% of new TB cases are drug resistant in parts of Russia, India and China
In Estonia, drug resistant cases jumped by 4.6% in one year
Unicef deputy executive director Andre Roberfoid said: "The cost of inaction is high.

"If we accept the proliferation of inadequate TB-treatment services and incorrect self-treatment - a real possibility in Asia - we face a rise in the incidence of multi-drug resistant TB (MDR-TB).

"That would be a humanitarian and epidemiological disaster."

Dr David Heymann, of the World Health Organisation, said the biggest concern was that drug-resistant TB would being increasing in other developing countries.

He said: "North America and Europe may have the billions of dollars required to contain this emergency. The worst affected countries in Asia, Africa and Latin America do not."

MDR-TB develops when TB patients begin but do not complete a full course of treatment with drugs.

When this occurs, the disease becomes much harder to treat - and far more costly.

Asia badly affected

Asia accounts for approximately 70% of all TB cases.

Ten Asian countries - Bangladesh, Cambodia, China, India, Indonesia, Myanmar, Pakistan, Philippines, Thailand and Vietnam - are among the 22 countries in the world with the highest number of cases.



We have to have adequate investment in resources in the UK to contain the spread of tuberculosis

Dr John Moore-Gillon, British Lung Foundation
Although two billion people are infected with TB, only a relatively small percentage ever develop the disease.

People whose immune systems have been weakened by the HIV virus are 30 times more likely to develop the disease.

There has been a quadrupling of TB cases in several African countries over the past 10 years as a direct result of HIV.

Children are especially vulnerable to the effects of TB, which is often difficult to diagnose in young children and therefore difficult to treat effectively.

Untreated, a person with infectious TB can infect as many as 15 persons in a year.

TB is also on the increase in the UK. In London alone TB has risen by 80% since the mid 1980s.

Dr John Moore-Gillon, of the British Lung Foundation, said: "We cannot afford to be complacent.

"World TB Day is an ideal opportunity to realise that TB is not from another country in another time - it's here and now.

"We have to have adequate investment in resources in the UK to contain the spread of tuberculosis. But we also need world wide political activity to prevent this historical scourge from being the world's dominant disease of the new millennium."

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See also:

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14 Dec 99 | Medical notes
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