Calls for action on 'dire' drug resistant TB threat in Asia and the Pacific | Asia Pacific

Calls for action on 'dire' drug resistant TB threat in Asia and the Pacific

Calls for action on 'dire' drug resistant TB threat in Asia and the Pacific

Updated 16 April 2014, 11:36 AEST

Medical experts are warning that drug resistant tuberculosis is now such a problem in the Asia Pacific region that it could overwhelm health systems.

They are calling on the Australian government to lead a comprehensive regional response.

Correspondent: Jemima Garrett

Speakers: Associate Professor Dr Ben Marais, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney

Dr Suman Majumdar, Centre for International Health, Burnet Institute in Melbourne

GARRETT: Drug resistant tuberculosis takes 2 years to treat and costs many times more than the milder form of the disease.

In a hard-hitting editorial in a recent edition of the medical journal of Australia four leading Australian TB experts warn that the Asia Pacific region is now home to more than half of the world's drug resistant tuberculosis, and it is spreading.

Dr Ben Marais from University of Sydney's Marie Bashir Institute for Infectious Diseases and Biosecurity, is one of the authors.

MARAIS: I can't think of a greater health challenge, together with drug resistance in general in all bacteria and viruses, for the Asia Pacific region. Especially TB is of concern, because it is a disease which is spread via the air and we have got very dense populations throughout South East Asia and pockets of high vulnerability. It will definitely be one of the biggest challenges for the region going forward.

GARRETT: Lead author Dr Suman Majumdar from the Centre for International Health at the Burnet Institute in Melbourne says the challenge posed by drug resistant TB globally is now 'similar in scale and impact to HIV infection in the 1980's'.

MAJUMDAR: Both diseases have had quite devastating effects on peoples lives and on health systems. The HIV story is remarkable. When it emerged it was killing thousands and it has killed millions each year and out international response has actually been quite incredible

GARRETT: Unfortunately, the global response to tuberculosis has not been on the scale of the response to HIV.

The Medical Journal of Australia editorial warns without additional funding an extra 1 million lives could be lost globally before the end of 2016.

Dr Marais says one of the big problems with TB is that is has never been seen as a 'sexy' disease.

MARAIS: We know there is a lot of stigma associated with being a TB patient but there is also a lot of political stigma associated so countries don't want to acknowledge a TB problem. It is viewed unfavourably. It is not something they want to discuss in public because it reflects possibly on their level of governance so on the whole countries in the Asia Pacific region are poorly prepared. We know that TB control-programs are grossly underfunded and especially with the rise of drug resistant TB, not a single country in the region has allocated adequate funds and most of the programs that are in place to control drug resistant TB are funded by the Global Fund with very little domestic commitment to address the problem.

GARRETT: The doctors warn drug resistant tuberculosis has the potential to overwhelm health systems in countries in Asia and the Pacific.

They are calling for a co-ordinated regional response, and for Australia to play a leading role, as Dr Majumdar explains.

MAJUMDAR: We would like leaders from the region to come together to, number one, prioritise this as a disease for their countries and across their region. The solutions to addressing it require some careful consideration and mapping out. The first step is getting this commitment, to say 'Look, we have a problem here', acknowledgement of that problem. From the Australian point of view, a co-ordinating function to facilitate the response would be the first thing. There is also an opportunity for Australia to really contribute in the key gap area which is investing in developing these new tools, into research and development but also contributing to ongoing implementation and scale-up of these treatment programs that exist. It is very important we do both together. The other issues that are broader and around the region would be exploring financing options, potentially to combat the disease, also procurement of drugs and control mechanisms across borders in these countries. It does require discussion but we think a regional summit and regional co-ordination is required.

GARRETT: You say the funding gap to fight tuberculosis is $US2.3 billion a year. The Australian government is in the middle of preparing a cost-cutting budget. Where so you see the money coming from to pay for this?

MAJUMDAR: Yeah, that is the global funding gap to achieve the global plan for TB objectives and it is significant. There are a couple of things Australia can do and I think, as the budget is coming up, it is important we consider this disease. The response can be through our aid program, it can also be through the medical research strategy, and the way Australia has been contributing already is great. We have been putting in to the Global Fund, we have been investing in Papua New Guinea in helping strengthen their TB program, and also some other bi-lateral initiatives to other countries, but I think we can look at a broader response. Whilst we should continue those 2 things, I think there is room to look at a regional mechanism. We have done similar things with other diseases like drug resistant malaria and supported a regional fund to co-ordinate that, and I think that is a great example to follow.

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