Countries need to act quickly or there will be an emergence of multidrug resistant strains of tuberculosis (TB), according to a World Health Organisation (WHO) report. The report was released on world TB day (March 24). "For the first time, we have evidence the drug resistant TB outbreaks that have shaken New York City and Russia are increasing elsewhere," said Dr Gro Harlem Brundtland (director general, WHO).
According to the report, resistance to at least one TB drug had increased by 50 per cent in Germany and Denmark since 1996 and resistant strains were nearly twice as likely to be found in foreign-born patients than native-born patients in these countries. The WHO report raises concerns over TB resistance increasing in developing countries which do not have the funds to cope with the problem. It cautions that the consequences of allowing drug resistance to flourish in the developing world will be felt elsewhere.
However, the report does provide some good news. It says that countries using DOTS (directly observed treatment short-course) - the WHO control strategy for TB, which aims to ensure patients take their medicines properly - have been able to prevent drug resistance from increasing. In China, drug resistance is three times lower in regions using DOTS than in regions not using the strategy.
In response, government officials from 20 countries meeting in Amsterdam on March 24 endorsed a declaration to stop TB worldwide. The declaration means that, in the short term, countries must provide readily available supplies of anti-TB drugs, easy access to and provision of treatment, and affordable medicines for drug-resistant TB. Long-term, strategies include the development of stronger, faster-acting drugs and an effective vaccine. A summary of the report can be found on the WHO website (http://www.stoptb.org).
A spokeswoman for the Department of Health confirmed on March 28 that the TB vaccine programme for schools was still suspended. She told The Journal that, while stocks were being delivered by Medeva Pharma (the manufacturer), the quantity was "insufficient". The full supply had yet to be delivered and there was still a backlog. She hoped that the problem would be corrected in the next few months. This was confirmed by Dr Francis Upchurch (medical director, Europe, Medeva Pharma) who said "we are aiming to supply and fill backorders by the summer" and that the company was currently on target to do so. The Department of Health was speaking to the World Health Organisation about finding an alternative supply to prevent this situation arising again, the spokeswoman added.