BY FRANCIS OKOYE
The current plans to f
ight and put an end to TB, Malaria and AMR By 2030, thereby meeting SDG goals seem to be in doubt, and may not become a reality.
Health experts gathered together in a webinar organized by citizen News service recently to discuss the issue. The Topic for discussion was “ Are TB, malaria and Anti microbial resistance (AMR) declining fast enough to meet SDGS by 2030?
Experts who contributed to the discussion, include Dr. Lucica Ditiu Exe Director, Stop TB partnership, Dr TIM France, Team Leader for External communication, Asia Pacific leaders malaria Alliance APLMA and managing Director, inis communication, Dr. Anna Nakanwagi Mukwaya, country director-uganda for International union against Tuberculosis and lung diseaes. The moderators include Ashok Ramsarp-former senior programme producer south African Broadcasting corporation SABC and shobka shukla, managing editor, Citizen New Service.
According to one of the moderators, Ashok Ramsarup, AMR is ignored so much by Health authorities in their fight against diseases that it is not even included in 2016 global action plan. Added to this is the alarming level of incidence of HIV/TB and malaria. He asked a burning question ,that as there is need to improve collaboration in fighting TB/HIV, can world Health organization TB strategy and Global action plan be said to be REALISTIC.?
IT IS BUSINESS AS USUAL
According to the experts, the end target globally by 2020 is actually business as usual, as it would be very difficult to realize the objective of end of TB by 2020.
Current efforts, the experts say will not end TB by 2035 but by 2182.
For the success of the fight against TB, they are 8 areas that change needs to take place that need paradigm shift
- Human rights or gender based approach
- Change and more inclusive leadership
- Change and patient driven approach
- Investment in social economic actions
- Integrated Health System fit for the purpose
- Innovative TB programmes equipped to end TB
- Mind set
- New, innovative and optimize approach to funding
THE NEED TO ELIMINATE MALARIA
On the need to eliminate malaria, it should be one of the best priorities of Health bodies worldwide. Malaria is a health burden of over 50 yrs, a huge drain on Economy, it keeps children out of school and cause several risk and resurgence of the disease is not helping matters.2 million people are at risk of having malaria, and risk of untreated malaria which is resistant to anti hemistin. Eliminating malaria is a problem in area, they should be health priority to eliminate malaria with specific programmes and the need for political leadership to stop malaria by 2030.By 2025, some 50% of regions that are prone to malaria will be malaria free that is the good news.
Countries can help in fight
Countries can help one another and the need for improved health facilities and a plan like the TB Plans, with 6 area of priority action would do a lot of good. These are as follows.
- United national efforts
- Service delivery
- Ensure high quality care
- Normalizing external alliance
- MDG’S opportunity to shift down and paragram shift- a reaction to SDG opportunity.
- Change way we operate
SDG not new ideology. We need to face real barriers on how to remove this disease jointly, need paragram shift of countries-to include Accountability, change which include transformed universal health coverage should come from countries. They should address market driven mindset as hardly many concrete efforts from them can be seen as 2017 approaches. They should organize mandate, they lack available platform, malaria, TB/HIV, AMR need model. The need for some significant changes is essential to the success of reduction in incidence of the disease worldwide
WHY NO MEANING REDUCTIONS IN TB, MALARIA AND AMR
Dr. Anna mukwaya, in her contribution, said that her country, Uganda is a high burden country for TB/malaria and that HIV is driving TB epidemic in Africa. She said that in the last 25yrs, have shown more prevalence of TB than what into estimated.
According to the expert, in many countries, they are very poor you don’t expect any meaningful reductions is TB malaria and AMR medicine are not available. Health system in many poor countries cannot be achieved because of poor health systems and much attention on individual disease not health systems.
To reduce incidence of TB, the need to reduce HIV new infection is important and provide all people with HIV Anti retroviral drugs. Also more support should be given by donors and national budgets. Urban areas, especially slums and hard to reach areas, need innovative interventions ,the expert said that we need to find men and treat them, as most survey show that men are missed by many TB program with huge gap between men that come to clinic.
THE CASE OF TB AND DRUG REISTANT
According to Dr. Caminero, Drug resistant TB can be avoided, and cured, that is the current situation mycobacterium TB resistance MDR and Extensively drug resistance TB, XDR-TB are included in this.
In 2014, 9.6 million TB cases were recorded with 101 million deaths; while 1.2m HIV/TB cases recorded 390,000 deaths compared with 480,000 MDR cases which recorded 190,000 deaths.
MDR TB accounts for 3% of all new TB cases. In 2013, 50% of new MD-TB were never treated of TB, Bad management origin of 50% of MDR-TB cases. XDR-TB can be avoided by strengthening national TB program with good management of susceptible TB cases and Dots. Every detection and cure of MDR/XDR –TB is key to avoid transmission. The 90-90-90 targets global plan, find 90% of TB cases in population (as 2.7m estimated missed cases in 10 countries) cure rate in most cases is 90% while detection is 65% detect 90% MDR TB and cure 90% by use of shorted MDR-TB regimes and incorporating of new drugs current MDR-TB success is 50-60% takes 14,600 pills to treat it before advent of shorted regime.
WHY FIGHT AGAINST HIV RECORDED MORE SUCCESS THAN THAT OF TB, MALARIA AND AMR
The fight against HIV has attracted community attention, has much more financing, advocacy not many people recognize that TB is a killer disease, advocacy within HIV has received much support.