Pakistan world’s 4th highest MDR-TB burden country

WHO National TB Control Professional Officer Dr Ghulam Nabi Kazi said that with a population of 177 million, it was currently estimated that there were around 620,000 TB patients in the country. “Every year, 410,000 new people develop TB with an estimated incidence of 231/100,000 population.”

Kazi said the prevalence rate of TB and HIV (human immunodeficiency virus) co-infection was around 1,500 and the TB mortality rate was 59,000 per year. “Tangible efforts to control this disease along scientific lines have begun since 2000 or 2001, although we had lifesaving drugs to cure TB and a cost-effective strategy for their use.”

He said that over the past 12 years, the national and provincial TB control programmes had been endeavouring to cure the infectious cases or the sputum smear-positive pulmonary TB patients on priority basis. “The targets for TB control that need to be achieved are 70 percent case-detection rate, and 85 percent treatment success rate with a view to lower the incidence, prevalence and mortality caused by the disease over time.”

However, he added, following the ethical and human rights viewpoint, it was also mandatory to detect and treat pulmonary smear-negative and extra-pulmonary cases with the same zeal.

He said the programme had a number of partners, including the Global Fund to Fight Aids, Tuberculosis and Malaria (which alone accounts for 90 percent of the spending); the WHO; the United States Agency for International Development; the Department for International Development; and the Koninklijke Nederlandse Centrale Vereniging tot Bestrijding der Tuberculose (Dutch TB Foundation).

He also said that while certain provinces had developed their PC-I, adequate funding was not being released to finance even the core activities of the programme. “Nevertheless, the programme has achieved steady progress since 2001 onwards without compromising on the quality of case-detection, case management and laboratory services.”

It has also been successful in involving tertiary-care hospitals and the private sector, including non-governmental organisations and inter-sectoral organisations, in service delivery and bringing about community mobilisation, he added.

Kazi said that last year, the national and provincial TB control programmes detected 284,806 TB cases, including 110,641 new smear-positive cases, indicating a case-detection rate of 69 percent for all TB cases and of 64 percent for smear-positive cases. “The programme achieved a treatment success rate of 92 percent.”

He said that it was against this backdrop that the Global Drug Facility mission visited Pakistan – and Karachi last week – and appreciated the performance of the Sindh Directorate of TB Control.

He complimented the provincial government on approving the PC-I of the TB control programme prepared with WHO’s technical support at a cost of Rs691 million until June 2015. “The requisite funds are not being released due to some procedural formalities, which need to be expedited.”

He described WHO as a strong technical partner of the national TB programme, which has been supporting the programme since its inception in 2001. “The WHO is supporting the programme in the areas of policy and plan development, monitoring and evaluation, and extensive operational research.”

Kazi said dependence on external donors would not augur well for the sustainability of the programme and the provincial government had taken a step in the right direction that needed to be taken to its logical conclusion.

He said he expected other provinces to follow suit. “The federal government is also supporting the programme through the Planning Commission and the Ministry of Inter-Provincial Coordination.”

Source: The News International