What can we do to tackle lung health?

Francis Okoye, CNS Correspondent, Nigeria
A webinar organized for the media by Citizen News Service, just prior to the 47th Union World Lung Health Conference, took a special look at lung health. Experts, who spoke on the matter, included Prof Jose A Caminero, Head of MDR-TB unit of International Union Against TB and Lung Diseases (the Union); Diana Weil, Coordinator policy, strategy and innovations unit,WHO Global TB programme; and Grania Brigden, the 3P Project Lead at the Union.

Priority actions to fight TB

(i)TB and poverty: Most people who suffer from TB are from poor countries and are also poor themselves. And this has made it difficult to fight the disease, because these poor nations do not have the funds to fight TB, and they do not deal with it on a war footing in most cases.

(ii) Improve diagnostics: Quality diagnostics for TB should be improved, and made available free, or very cheap, so that most can afford it. To increase TB/MDR-TB detection, rapid molecular and sensitive drug susceptibility tests(like GeneXpert), should be used for all presumptive patients.

(iii) Provide social security: TB patients should be given financial assistance during the course of treatment, in order to take care of their families and themselves, since TB robs them of precious work hours they would have used to fend for their families.  NGOs ,governments  and corporate organizations can do this. It is not enough to just provide free drugs and free treatment to TB patients, 90% of whom are poor, and where do we expect them to find food to eat while on medication and to take care of their families.

(iv) Political will: Countries should pass laws that will ensure meeting the 90-90-90 targets of the 2016–2020 Global Plan to End TB— reach 90% of all people with TB in the population, reach at least 90% of the key populations; and achieve at least 90% treatment success for all people diagnosed with TB. Policy makers should include TB as a priority health problem to be tackled by all. That is not the case in many poor countries were TB burden is high.

(v) Shorter MDR-TB treatment regimens: The WHO approved new short MDR-TB treatment regimens should be made available in all countries, as they are better tolerated, more effective and take shorter time to complete the treatment. Only 23 countries in Africa and Asia have introduced the short regimen for treatment of MDR-TB.

(vi) Tackle MDR/XDR-TB: We have to increase detection and cure rate for MDR-TB, which boasts of 500,000 new cases and 200,000 deaths every year. There are about 50,000 new cases 30,000 deaths from XDR-TB every year. Shortened MDR-TB regimes should be used and so also new drugs like Bedaquiline, and Delamanid. The current MDR-TB regimes success outcome is 50%-60%.

(vii) Strengthen National TB Control Programmes: There is urgent need to strengthen them at country level. Many of the programmes are not properly funded and depend largely on international donors. They also do not have effective stand alone programmes to fight TB. Countries should make more efforts to generate domestic funds internally so as to make the programmes sustainable.

(viii) Media engagement:The media needs to be involved more to send out appropriate messages around lung health, especially TB, to the public. Efforts should be made to engage the media in the same way HIV/AIDS campaigners engage it in order to bring AIDS to the front line.

(ix) Break the myths around TB: Since TB breeds more in poor countries, it draws strength from superstitions which abound in such countries. People in some African countries still believe that they have been poisoned or attacked spiritually, when they show symptoms of TB and other lung health diseases. In my country Nigeria, it is also believed that one could get TB by it being sent spiritually through ‘Juju priest’ to a person. That is not all. Many traditional and alternate medicine practitioners claim to cure TB, and Nigeria’s National TB Control Progarmme and Ministry of Health seems to be oblivious about this. Their silence makes the average Nigerian believe that such fake remedies do work. So TB patients flock to these faith healers and only come to the hospital after they develop complications or drug resistance. Another attraction is the promise of these so called healers and doctors to cure the TB patients within a few weeks and at a much cheaper rate. Money by international donors should be channelled to NGOs in poorer countries to fight superstition if TB is to be eradicated.

Francis Okoye, Citizen News Service - CNS
November 19, 2016