TB patient

The challenges of ending Tuberculosis (TB) in Bangladesh and beyond

Each year, we commemorate World Tuberculosis (TB) Day on March 24 to raise public awareness about the devastating health, social and economic consequences of TB, and to step up efforts to end the global TB epidemic.

The date marks the day in 1882 when Dr. Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease.

TB remains the world’s deadliest infectious killer. Each day, nearly 4,500 people lose their lives to TB and close to 30,000 people fall ill with this preventable and curable disease. Global efforts to combat TB have saved an estimated 54 million lives since the year 2000 and reduced the TB mortality rate by 42%.

To accelerate the TB response in countries to reach targets – Heads of State came together and made strong commitments to end TB at the first-ever UN High-Level Meeting in September 2018.


KNOW KEY FACTS ABOUT TB

The theme of World TB Day 2019 — ‘It’s time’ — puts the accent on the urgency to act on the commitments made by global leaders to:

  • Scale up access to prevention and treatment
  • Promote equitable, rights-based and people-centered TB response
  • Ensure sufficient and sustainable financing including for research
  • Promote an end to stigma and discrimination
  • Build accountability
BANGLADESH SCENARIO:

There is a huge TB burden in Bangladesh. In Bangladesh, the numbers of the incidence of TB in the population is not going down dramatically. That means we have a long way to go to combat the disease. Moreover, the burden of drug-resistant TB is on the rise.

The burden in the urban area and some pocket areas in the country is an added threat. On top of this, the prevalence of TB patients in some particular population like children, healthcare providers, HIV/AIDS patients are very difficult to handle.

Whereas the government is trying to extend support to the patient pool, there is obvious resource constraint that hinders the pathway to curve down the number of patients with a very short period of time.

Although the donor communities are supporting the government to mitigate the problem, there are ample opportunities to deal with the TB burden.

 
Dr. Abu Jamil Faisel, a Senior Technical Director of ‘Challenge TB’ project funded by USAID, expressed his optimistic view of combating the disease. But again, considering the constraints at different avenues, the fight is not likely to be short-lived.

In an interview, he highlighted some dire need for improvement in the holistic efforts to end TB. Like many other development initiatives, the lack of coordination with different government mechanisms and bodies are very crucial.


 

Recently, the report “Building a tuberculosis-free world: The Lancet Commission on tuberculosis” published the country report cards. It clearly revealed the room for paying immediate attention including the political will.

It is a matter of hope that the Government of Bangladesh is already committed to lowering the disease burden. But it just needs a boost and some additional robust emphasis form the top level of country leadership.

Charka Challenge TB

GLOBAL SCENARIO & INITIATIVES:

WHO has launched a joint initiative “Find. Treat. All. #EndTB” with the Global Fund and Stop TB Partnership, with the aim of accelerating the TB response and ensuring access to care, in line with WHO’s overall drive towards Universal Health Coverage.

On this World TB Day, WHO calls on governments, affected communities, civil society organizations, health-care providers, and national/international partners to unite forces under the banner “Find. Treat. All. #EndTB” to ensure no one is left behind.

It is time for action! It is time to End TB. It is time to bring tuberculosis out of the shadows.

Eng TB

NEW WHO RECOMMENDATIONS TO ACCELERATE PROGRESS ON TB:

WHO has issued new guidance to improve the treatment of multidrug-resistant TB (MDR-TB). WHO is recommending shifting to fully oral regimens to treat people with MDR-TB. This new treatment course is more effective and is less likely to provoke adverse side effects. WHO recommends backing up treatment with active monitoring of drug safety and providing counseling support to help patients complete their course of treatment.

The recommendations are part of a larger package of actions designed to help countries increase the pace of progress to end tuberculosis (TB) and released in advance of World TB Day.

“The theme of this year’s World TB Day is: It’s time to end TB,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “We’re highlighting the urgent need to translate commitments made at the 2018 UN High-Level Meeting on TB into actions that ensure everyone who needs TB care can get it.”

Since 2000, 54 million lives have been saved, and TB deaths fell by one-third.  But 10 million people still fall ill with TB each year, with too many missing out on vital care.


 

The WHO package is designed to help countries close gaps in care ensuring no one is left behind. Key elements include:

  • An accountability framework to coordinate actions across sectors and to monitor and review progress
  • A dashboard to help countries know more about their own epidemics through real-time monitoring – by moving to electronic TB surveillance systems.
  • A guide for effective prioritization of planning and implementation of impactful TB interventions based on analyses of patient pathways in accessing care.
  • New WHO guidelines on infection control and preventive treatment for latent TB infection
  • A civil society task force to ensure effective and meaningful civil society engagement

“This is a set of pragmatic actions that countries can use to accelerate progress and act on the high-level commitments made in the first-ever UN High-Level Meeting on TB last September,” said Dr. Tereza Kasaeva, Director WHO’s Global TB Programme.

Tareq Salahuddin

Dr. Tareq Salahuddin is an award-winning journalist and a Special Correspondent of News Hour. He is a Public Health Professional working in the development sector. Dr. Tareq, a medical graduate, is a member of Public Health Association of Bangladesh and a former member of the Governing Council and Policy Committee of the World Federation of Public Health Associations (WFPHA), a J2J Fellow on HIV/AIDS and a member of the International AIDS Society. To know more about Dr. Tareq, please visit his personal website (www.tareqsalahuddin.net) or simply Google his name.
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