MANILA, 23 March 2009—The World Health Organization (WHO) today stressed the urgent need for countries to strengthen their national health systems to prevent the further spread of tuberculosis (TB), especially in the wake of multidrug-resistant TB (MDR-TB).
Despite gains made using DOTS, the WHO-recommended TB control strategy, WHO said it is not sufficient to simply control the spread of TB. "Our available tools work, but they are not enough," said Dr Shin Young-soo, WHO Regional Director for the Western Pacific. "To progress, we must think bigger and look beyond DOTS to the actual setting in which TB programmes operate—national health systems."
World Stop TB Day 2009, on 24 March, is focusing on the delivery of TB care through strong health systems. Effective TB control has been hampered by weaknesses in health systems, such as chronic staff shortages, inadequate financial resources, poor laboratory capacity, low access to quality care, and flawed links between service providers in the public and private sector, Dr Shin said.
Some 5000 new TB infections occur daily in the Western Pacific Region alone—a situation made more troubling by the added threat of multidrug-resistant TB. People with MDR-TB are resistant to at least two of the best anti-TB drugs. MDR-TB also takes much longer to treat, sometimes as long as two years, and is more expensive than treating ordinary TB. The treatment also causes more severe side-effects, such as liver malfunction and severe gastrointestinal problems.
"The risk of an epidemic of TB that does not respond to drugs compels countries to take action," Dr Shin said. "We cannot tackle multidrug-resistant TB when most laboratories lack sufficient number of skilled technicians, as well as the tools to identify cases."
WHO stressed that a competent and motivated workforce is fundamental to the success of TB control programmes. There needs to be strategies to recruit, train, retain and motivate staff, including better salaries, promotions, and other incentives.
Governments also need to ensure that TB treatment is free of charge. WHO said out-of-pocket expenses deter patients from seeking care. Financial mechanisms should, therefore, be put in place to support the TB control programme.