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WHO Declares Drug-Resistant TB a Public Health Crisis

By Cheri Cheng | Update Date: Oct 24, 2013 11:50 AM EDT

Due to scientific and technological advances, medical treatment and diagnoses for some diseases have improved significantly over time. Diseases, such as malaria and polio, have almost been eradicated throughout the world. Despite progress, the World Health Organization (WHO) recently announced that the war against drug-resistant tuberculosis needs to be strengthened. According to WHO, the majority of drug-resistant TB cases was undetected or unreported in 2012.

Based from the analysis of TB cases in 2012, WHO reported that drug-resistant TB is a huge problem that governments have yet to address properly. In 2012, the organization estimated that there were 450,000 cases of multi-drug resistant TB. However, only 94,000 cases were reported with only 77,000 people receiving proper care. The remaining 17,000 patients were left on waiting lists due to the lack of medicine. These numbers rose from 2011 statistics that reported 62,000 diagnosed cases of multi-drug resistant TB. For XDR-TB, which is even more drug-resistant strain that is harder to treat, 2012 had 2,230 cases, which is also an increase from 2011's 1,464.

"This is a public health crisis," said Mario Raviglione, director of the WHO's global TB program. "You cannot afford to make a diagnosis and not be able to treat patients. We consider that an ethical issue."

According to WHO, the 17,000 people who were left untreated reveals the imbalance between diagnosing patients and treating them. Drug-resistant TB is currently diagnosed using Xpert MTB/RIF testing, which is created by the U.S. Company, Cepheid. Xpert MTB/RIF testing can detect TB and what the TB is resistant to in 100 minutes. As of June 2013, 3.2 million Xpert MTB/RIF tests have been done to diagnose patients. Currently, 88 countries utilize it.

Even though the test is effective in diagnosing patients, the numbers reveal that some countries were not prepared to care for all of the diagnosed patients in 2012.  These countries did not get enough medications and did not have enough medical staff to administer care. WHO reported that some of the countries with the largest waiting lists were South Africa, China and Pakistan. In some African countries, only 51 percent of the total number of cases was treated. The organization also found that the ratio of people being diagnosed with multi-drug resistant TB to the number of people enrolled in treatment increased by 10 percent.

Lucica Ditiu, executive secretary of the Stop TB Partnership, a network of organizations involved in TB, stated according to the Wall Street Journal, "There are not enough people to give the drugs. Who will do it? Who is available and trained?"

WHO also reported that in 2012, there was an estimated 8.6 million cases of TB with around 1.3 million deaths. Based on the estimated total number of cases, the organization believes that around four-fifths of the drug-resistant cases, 2.9 million, were left undiagnosed in 2012.

 "This disease should be a disease of the past," Ray Chambers, a U.N. special envoy for health financing, said. "We have to find those three million people and test and treat them."

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