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Thursday, March 25, 1999 Published at 01:08 GMT

World: South Asia

South Asia urged to fight tuberculosis

Bangladesh: A tuberculosis programme is being put in place

By South Asia Analyst Charles Sanctuary

The World Health Organisation says the response of some South Asian governments to the tuberculosis epidemic has been inadequate.

According to a new WHO report, there are eight million new cases of TB in the world every year, and many of those afflicted are found in South Asia.

The WHO warns that unless urgent action is taken, drug resistant strains of the disease will rapidly multiply.

[ image: The WHO wants countries to follow its TB programme]
The WHO wants countries to follow its TB programme
The health organisation says the worldwide spread of TB can be curtailed, since effective and inexpensive treatment is available. However, only 16% of sufferers currently receive it.

India, Pakistan and Bangladesh are among the top 22 countries worst affected by the disease, which currently kills nearly one million people across the globe every year.

They top the list of countries with the highest number of TB cases that do not have access to WHO-recommended treatment.

The figures for India alone show there are 300,000 deaths, and one million new cases annually.

The number of people becoming infected is also growing across the whole region.

Dr Paul Nunn of the WHO said women in South Asian countries were at particular risk.

Commonest cause of death

"It's probably the commonest cause of death of young women between the ages of 15 to 44 throughout South Asia - as it is indeed for the rest of the world.

"And the sad thing about it is that these deaths are preventable.''

The WHO is calling for governments to make greater use of its recommended programme: Directly Observed Treatment - Short Course.

The health body says DOTS has stopped the spread of TB and the emergence of drug resistant strains in areas where it has been adopted.

Antibiotic resistance increasing

The programme requires patients to take their medicine under supervision to ensure they complete the course of treatment.

The WHO is urging both India and Pakistan to make greater efforts to combat the disease, as failure to complete treatment programmes is leading to multi-drug resistance.

It says antibiotic resistant cases of TB are increasing around India's capital, Delhi.

Dr Nunn said the treatment of TB is often not a government priority in the South Asia region, but in some areas there is room for optimism.

He said: ''In Bangladesh for example, for the last four of five years there's been a very rapidly expanding nationally based TB control programme, which now covers virtually the whole country.

''And it's producing very high treatment success rates. In India at long last things are beginning to move, and as we speak drugs are being distributed to some one quarter of the country's health districts.''

The WHO hopes a new initiative with the World Bank and a coalition of non-governmental organisations will mean further advances in combating the problem.

Its message is that while cases of TB are growing, the disease can still be eradicated.

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