World Tuberculosis Day falling on Saturday the 24th March is being commemorated all over the world including Pakistan with commitment and renewed enthusiasm to save lives from a preventable and curable disease. Elaborate programs have been organized on this occasion.
The WHO Representative in Pakistan Dr Guido Sabatinelli has called for all out efforts to contain this problem so that the younger generation can get a chance to see a world free of Tuberculosis. He warned that in a country with the fifth highest burden of Tuberculosis and a high prevalence of drug resistant Tuberculosis there can be no room for complacency. He expressed satisfaction over the efforts of the national and provincial programs for TB Control and assured the absolute support of the WHO in this regard. He pointed out that WHO had supported operational research that will ascertain the correct prevalence and incidence of the disease. “The results of the Prevalence Survey will be known before the end of the year.” He thanked the GFATM, USAID, DFID, JICA, UNHCR and IOM who along with a number of other national and international partners were contributing to TB control.
Giving details of WHO support to the National Tuberculosis Control Program, Dr Sabatinelli mentioned that his organization carries out program evaluations through Annual Joint Review Missions, technical support to laboratory services, human resource capacity building through regional and country level training, data management, procurement of equipment, MDR-TB management, emergency financial support for the procurement of drugs and operational research.
The UN Secretary General Ban Ki-Moon has described TB as a neglected disease which has caused much suffering and is yet to be controlled, and urged communities to benefit from the availability of TB treatment which could help prevent and finally stop TB and called for intensified global solidarity driven actions in the fight against TB. The Secretary General has also written to President Asif Ali Zardari and heads of state of other TB High Burden Countries urging them to enhance attention and commitment to TB control.
The World TB activities this year have been themed around the slogan of “Stop TB in my lifetime” reflecting a desire on behalf of every individual to see end of this centuries old though easily preventable and treatable disease. The theme also urges action on a neglected area in TB control namely childhood TB.
Dr Ala Alwan, the Regional Director of WHO Eastern Mediterranean Region in his message on TB Day has appreciated the hard work of everyone involved in the fight against TB as countries have been successful in detecting more TB cases, expanding care for the MDR-TB like complex forms of the disease and progressively moving ahead towards MDG targets through innovative partnerships. However, Dr Alwan also warned of threats faced by TB control posed by declining financing from donors like the Global Fund.
Dr Mario Raviglione, the Director of the WHO HQ Stop TB Department praised global progress in TB control citing slowing death rates by 40% overall compared to 1990 and saving millions of lives. However, he said unfortunately, to a large extent, children had been left behind, and childhood TB remained a hidden epidemic in most countries. He said it was time to act and address it everywhere.
Dr Ghulam Nabi Kazi, WHO National Professional Officer for TB Control highlighted the urgency of the matter and emphasized that it was an effort not only against the disease but time as well. As efforts to increase the case detection rate are being accelerated, TB control can possibly be one of the Millennium Development Goals that Pakistan can hope to achieve by the targeted date of 2015. However it will entail a considerable increase in the pace of effort with greater involvement of the private sector, as public health victories do not come about by default but require a conscious and deliberate effort, he added.
With an estimated population of around 180 million, the annual incidence of Tuberculosis in Pakistan is 231 per 100,000 population indicating 420,000 new cases every year. During 2011, a total of 270,422 cases, approximately half of which are women, were detected who have completed or are undergoing treatment while the treatment success rate in 2010 was 91% with a low default rate of 3%.
Although the Government of Pakistan adopted the TB-DOTS strategy in 1995, it was implemented quite late in 2000-2001. The real impetus to the program came after the adoption of the Islamabad Declaration on 24th March 2001 calling upon the government and all its partners to carry out a crusade against Tuberculosis. Substantial progress has been achieved in the intervening 12 years giving rise to a fair degree of optimism. However, with a prevalence of TB patients over 700,000 and drug-resistant strains of TB increasing, all the stakeholders in TB control in Pakistan will need to accelerate the fight against Tuberculosis with absolute dedication and commitment in order to secure a better and hopefully TB free nation for our young children.