Until recently, tuberculosis (TB) was the leading cause of death for all of mankind. Even in the ‘60s, it was still a killer in B.C. Sadly, we dropped the ball. It’s human nature. We solved it here, elsewhere is out of sight, out of mind. But TB didn’t stop elsewhere and the ancient killer is back. Only now it’s in new, mutated versions including Multi-Drug Resistant (MDR), Extensively Drug Resistant (XDR) and completely drug resistant versions, including a particularly virulent version which kills in less that a month.
TB is air-born and spreads easily. There is no prevention and for some, no cure. Recovering confers no immunity — you could catch it again, the next day.
First the bad news:
TB is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent
In 2012, almost nine million people fell ill with TB, of whom three million were never diagnosed
1.3 million died from TB, including 74,000 HIV-negative children
A TB outbreak in 2008 in Kelowna has not been stopped. In 2012, there were twice as many cases as the year before
XDR-TB is an extremely expensive disease to cure with up to two years of harsh chemotherapy
Cost for one cure of XDR-TB ranges from $100,000 to $1 million per case. Even then, 1/3 of cases die
Multi-drug resistant TB (MDR-TB) is present in virtually all countries surveyed
B.C. has many international airports. We are one airplane load away from having 200-plus folks exposed to MDR or XDR TB landing on our already overburdened health care system, exposing, on average, 15 people before being detected
On the positive side:
The TB death rate dropped 45 per cent between 1990 and 2012
An estimated 22 million lives saved through use of Direct Observation Treatment Short-course (DOTS) and the Stop TB Strategy, including TB REACH
Using DOTS, China cut TB rates in half in only 20 years
A plan is in place to reach the last three million
Defeating this ancient scourge is a long-term problem but the first step is right in our grasp. DOTS is a cheap and effective way of treating regular TB. We use it in B.C. to treat our own citizens. Expanding DOTS everywhere is the key to wrestling TB under control around the globe. But to use DOTS we need to find those who are infected.
TB REACH is a proven initiative for diagnosing the hardest to reach.
In 2009, Canada pledged $120 million to the Stop TB Partnership to found the TB REACH initiative — an innovative mechanism focused on using community-driven programming “to promote early and increased case detection of TB cases and ensure their timely treatment, while maintaining high cure rates within the national TB programmes.”
TB REACH focuses specifically on finding and diagnosing cases of tuberculosis in the most vulnerable, hardest to reach regions of the world
The small, highly focused funding formulas encourages grassroots, community-based initiatives designed to reach right into the communities at risk
Many of the programs are utilizing new technologies and methods of case detection to find as many people and diagnose as many cases as possible
TB REACH is now focusing on the last few, most difficult places to reach. It is creating new partners on the ground and designing programs to reach the last three million
TB REACH has so far supported 109 projects in 44 countries through the first three waves of funding. The externally validated results of the first wave of funding showed an average 33 per cent increase in case detection with a few projects even doubling the case detection within one year of implementation.
Ultimately, defeating TB is going to need new drugs and a vaccine but the first step is wrestling plain old fashioned TB to the ground around the world. The TB REACH program is doing just that.
The TB REACH program has a practical five-year plan in place that will see it reach everyone in the world with detection and treatment. This five- year round of financing calls for us to make a commitment of a new $40 million USD per year, about three cents per week, per Canadian. While this may sound expensive, it is many orders of magnitude cheaper than treating a large scale outbreak of TB just here in B.C.
With this week’s World TB Day, call or write to your MP and say you want TB to be stopped for good with funding for TB REACH. Why not make the call or write the letter and save millions of lives? One of the lives you save may be your own.
Okanagan-Shuswap MP Colin Mayes can be reached at 250-260-5020.
Leo Young has been a citizen activist with RESULTS Canada for 10 years and is with RESULTS Vernon, which meets every second Thursday at the People Place at 7 p.m. See www.results-resultats.ca
