WHO calls for widespread free access to anti-TB drugs for people living with HIV

"Anti-TB drugs and quality care are currently not available for over 70% of TB cases among Africans living with HIV

Editors of “Colors” magazine document the worsening global TB/HIV crisis.

15 July 2003 | PARIS --

The World Health Organization today called for free anti-TB drugs (ATDs) and quality care to be made widely available to people living with HIV, along with renewed efforts to increase access to anti-retrovirals (ARVs) in developing countries. Currently, tuberculosis is the biggest killer of people with AIDS.

ATDs are a cocktail of medicines comprised of isoniazid, rifampicin, pyrazinamide and ethambutol that, when taken properly, are more than 95% effective in curing tuberculosis regardless of a person’s HIV status. ATDs cost only $10 per patient for the entire course of treatment.

Dr Mario Raviglione, acting director of WHO’s Stop TB Department, stressed that “Ten years after an unprecedented declaration of a global tuberculosis emergency by WHO, the TB epidemic has grown even worse, primarily due to the spread of HIV. We need to increase our efforts to address the deadly synergy between the two diseases, each of which is fuelling the other’s impact.”

An estimated one third of the 42 million people living with HIV/AIDS worldwide are co-infected with tuberculosis. Approximately 90% of people living with HIV die within a few months of becoming sick with TB if they do not receive proper TB treatment.

In Africa, HIV is causing tuberculosis to spread so rapidly that DOTS* TB treatment services cannot keep pace. HIV attacks the immune system, allowing the bacteria which causes TB to multiply and spread more easily. HIV is causing a 6% annual increase in the number of TB cases across sub-Saharan Africa. Meanwhile, DOTS tuberculosis treatment services are also expanding but so far only at a rate of 2%.

According to Dr Raviglione, the ATDs used with the DOTS treatment strategy made it possible to cure tuberculosis in over 80,000 Africans living with HIV last year. However, more than 200,000 Africans with HIV died from tuberculosis because they had no access to ATDs and DOTS services.

An even greater TB/HIV crisis may be emerging in India according to WHO. HIV is spreading rapidly in the country which has the largest number of TB cases in the world. There are already 180,000 Indians living with HIV who are also infected with TB. Fortunately, the DOTS programme in India is one of the most rapidly expanding programmes in the world.

ATDs used through the DOTS strategy can prolong the lives of people living with HIV by years at a cost of approximately US$ 200.00 for the entire 6-8 month treatment period including health service and staff costs.

Tuberculosis – A Bold New WHO Report

“In Africa, it strikes us as peculiar how politicians and academics can speak of ‘their AIDS initiative’ or ‘their TB program’ as if the two diseases are not related,” said Winstone Zulu, a Zambian man infected with HIV who had repeated bouts with TB until finally being cured of the disease with the DOTS strategy. “For me and my family, HIV and TB have always been seen together conspiring and collaborating to steal away our health.”

The real human costs of tuberculosis experienced by others who have faced Winstone Zulu’s plight are chronicled in a new report released today by the World Health Organization, which supports their call to increase the availability of ATDs and DOTS treatment services for people living with HIV and TB.

The publication, prepared for the World Health Organization by editors and photographers from Colors magazine, puts a human face on the TB epidemic and the deadly interaction between TB and HIV. Outlining the efficacy of the DOTS programme, the report makes clear that continued commitment and expanded resources are vital to combat TB.

“The images are disturbing,” said Colors editor-in-chief Renzo di Renzo, “but in fact they give just a mere glimpse of the enormous challenges faced every day by TB health care workers.”

Despite eight million new cases being reported annually – and two million deaths a year – the report reveals the many misconceptions people have about the disease and how this ignorance is reflected in the misery of those infected with TB across the world.

The new TB report, including photographs, can be accessed here . "

2:20:29 PM    

Scooters in corridors

It wasn't done for April Fools' Day.  A I wonder if it'll catch on. (I want one please)

Herkner H., Eisenburger P., Havel C. and Laggner A.N., Dashing with scooters to in-hospital emergencies: a randomised cross-over experiment. Resuscitation March 2002; Vol. 52. Issue 3. pp. 293-6.

Abstract

Objective: Physical exhaustion is a frequent condition in emergency medical teams after in-house emergency runs, which might affect the quality of advanced care. Newly available light-weight scooters may reduce exertion as measured by the cardiovascular response in these circumstances and, therefore, may reduce physical exhaustion on arrival.

Methods: We undertook a randomised cross-over trial in a simulated in-house emergency alarm run to examine the influence of scooting compared with conventional running on pulse rate (primary outcome), manual skillfulness and response time.

Results: We tested 24 emergency department professionals in eight emergency medical teams. After scooting the pulse rate was significantly lower compared with conventional running [157 (IQR 145–169) vs. 170 (IQR 154–175) min-1, P=0.004]. After the simulated emergency alarm run no difference was found in manual skillfulness and response time between scooting and running.

Conclusion: Using scooters for simulated in-house emergency alarm runs markedly reduces the cardiovascular response of emergency medical teams.

The study was carried out in Vienna, Austria.  Who says Bavarians do not have a sense of humour.

2:11:40 PM    

John Wesley

One of my friend's dad is a Methodist Minister. In their house is the fllowing on a rather austere plaque on the wall-

Do all the goood you can

By all the means you can

In all the ways you can

In all the places you can

All the times you can

To all the people you can

As long as ever you can. 

2:08:18 PM