World TB Day: Preventable and curable, but affecting millions

Dr Ibrahim Abubakar

110744586 300x197 World TB Day: Preventable and curable, but affecting millionsThis year, as always, the world marks World TB day with the aim of raising public awareness of TB and commemorating the discovery of the bacteria that causes tuberculosis by Robert Koch in 1882. The theme selected to mark this year’s event is “Stop TB in my lifetime” which focuses on a world free of TB in the lifetime of today’s children, and a world free of TB deaths in the lifetime of today’s adults.

Although TB kills nearly a million and half people every year and nearly nine million individuals suffer from this largely preventable and curable disease, the global effort to tackle TB has been modest until fairly recently. Public awareness is generally not high. There still exists some real misunderstandings about the infection. TB requires close, prolonged contact with somebody who has the infectious form of the disease in order for it to be passed on. There is also no red ribbon or poppy to symbolise the disease which afflicts so many globally, so this may be why over the years it has not reached the same level of global awareness as some of the other infections which currently burden the world.

It is therefore interesting that this year the global Stop TB Partnership, which coordinates wider societal and stakeholder involvement in the effort to control TB, has decided on a message which encourages people world-wide to make a personal call for priorities in TB prevention and cure.

For many in the west, TB is largely seen as a disease that affects poor countries. While the highest burden of TB is predominantly borne by poor and middle income countries, TB rates continue to remain high in major cities in Europe and North America. London, for example, has been described as the TB capital of Europe as it has seen a resurgence of TB on a scale not seen in any other western European capital in the last two decades. The number of new cases of TB every year in the London Borough of Brent is comparable to that in Karonga district in Malawi. It is therefore appropriate that any intervention provides an effective means to identify cases promptly and ensure that they complete treatment. Urban TB control remains a priority for low TB incidence countries.

There is, however, hope. Recent estimates from the WHO suggest that we are likely to meet the Millennium Development Goal (MDG) of falling TB rates globally by 2015. Research funding has increased over the last decade and promising new candidate vaccines and drugs are being evaluated by researchers. New tests that help to rapidly detect TB are also becoming available. We are gaining new insights all the time into how the infection is transmitted and how it causes disease. In the UK, new guidance released today by the National Institute for Health and Clinical Excellence (NICE) aims to tackle some of the issues which health services encounter when trying to target TB prevention at hard to reach groups, such as immigrants, homeless people, problem drug users and prisoners.

So, what more can we do? There is a funding gap for the development of new antibiotics, tests to diagnose TB and a vaccine to prevent the illness. The call by the Stop TB partnership for all of us to take action and demand that TB is controlled is timely and appropriate. Examples of action that people can take to reduce the global burden of TB include: volunteering for the UK’s leading national TB charity, TB Alert, which works locally as well as in high burden countries, encouraging and influencing our MPs to prioritise TB control and action, and encouraging more funding for critical research into TB control efforts.

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  • kawasakiman

    There is no profit in curing things. Un-ending treament is where the real profit is.

  • hectorsmum

    TB was seen eventually by those who sought to cure it, as a disease caused by poverty. Oh I am well aware that during the past times it affected the rich, but this was generally because it was in the general population. It is certainly likely to become another disease which will be difficult to cure as antibiotics will have difficulty with the resistant strain which is apparently in the US. We need to get homeless people into homes firstly and give people enough money to feed themselves properly. I certainly do not want to see a return of this disease as it used to be, my Mother died of this just when the cure had been found, she was one of the unlucky ones.

  • Europeanonion

    I had TB as a child its effect has been profound. In those days one spent months in a sanatorium which, at an early, that separation that it inflicted, was influential. The free movement of people under EU rules and the lackadaisical policing of our boarders is an obvious invitation to this deadly disease to make its return. Consumption is not the prettiest of thing to succumb to; it is disfiguring and increasingly resistant to modern medicine. In a sort of reverse morality that only modern mores can attempt we are told about London and the 40% of all UK cases of TB in this country and asked to contemplate the immigrants living under railway arches. So this is the modern world which immigration acceptance contrives? I would want to know what these social misfits are doing here rather than trying to drum-up sympathy for them, there is both the failure of brotherhood and the outrageous failure of politics that contemplates these wandering bands. Their situation informs us that they are self-evidently not being of use to Britain in commercial terms and their accommodation here can only invite us into a third world of exotic disease which, in our advanced civilisation, we should be protected from, we who having been subjected to too much modern medicine and who have developed vulnerability, where doing ‘good works’ only brings everyone into danger. TB should be flying yellow or black ‘plague flag’ in many countries whose people have been coerced to come here. They should be contained until they are cured of this infestation, their trafficking halted. This warning concerning TB has highlighted the incalculable harm that certainty of movement and lack of control wreaks on the unsuspecting. People living under archways, and not just the escapees from our own dysfunction? We now invite people here for whom we obviously have no use and little purpose other than in allowing us to spout hollow sentiments about the efficacy of the EU and its policies, vacuous rhetoric affirming the spirit of freedom? The EU has been wrong in so many of its contentions that we should be fearing its certainty. We already have too many people for whom the State is constantly campaigning against, the cost of sustaining and the blooming of social problems in relation to the really big issues of land use, demography, authority, the massive and elusive price that we all pay for the maintenance of our high-bred status, the constant reshaping of expectation in its downgrading which is in direct ratio to higher cost of that shortcoming. We can be caring, watchful, sympathetic, energetic on behalf of people with little current expectation but, as in the case of tuberculosis, it should not be exercised here. We have a right to practice civilised behaviour but we do so from a position of strength. Being devoured by an alien and irresistible disease is a curse which is entirely avoidable and does not have to be the instance of small pox infecting an unsuspecting, latter day, world. The Government has a responsibility to act on behalf of the innocents that it has to protect without taking on responsibilities for which it is ill-equipped and too guided by financial perturbation to affect a responsible and radical solution. This is yet another accord with Europe which should be broken; isolationism is no bad thing when matters are so threatening.

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