TB kills an estimated one and a half million people each year, with 60 percent of new cases in Asia.
Dr Mel Spigelman who heads the Global Alliance for TB Drug Development, is visiting Australia to warn that drug-resistant cases of the disease pose a threat not just to the countries affected, but the wider world.
Presenter:Bill Birtles
Speaker:Dr Mel Spigelman, head, Global Alliance for TB Drug Development; Curt von Boguslawski, Country Program Manager, World Vision, Papua New Guinea;
BIRTLES: Across Asia, efforts to reduce the number of Tuberculosis cases appear to be making progress. While Asia still accounts for 60 per cent of all the new cases, there have been big reductions in TB rates in recent decades, in countries, including China and Cambodia.
Worldwide the disease is primarily found in developing countries, but Mel Spigelman for the Global Alliance for TB Drug Development, says the reach of Tuberculosis is wider.
SPIGELMAN: So first, it's important note that there is no country that is not affected. So as opposed to some of the other neglected diseases, TB is truly a global disease affecting every country of the world. But TB is also a quintessential disease of poverty, and therefore it mostly affects the poorer countries and within every country, it affects the poor of the poor.
BIRTLES: He says in Sub-Saharan Africa, where the disease is heavily linked with HIV, TB rates are getting worse, but in Asia, they're on the decline.
Mel Spigelman says the real danger is the growth in multiple drug resistant forms of the disease.
SPIGELMAN: So interestingly enough, drug-resistant TB in general arises on from a manmade situation where you treat TB and the TB treatment is not really done well. There's not good compliance and a lot that's related to the difficulty of the treatment, so there's no spontaneous mutation that causes drug-resistant TB just to form in any person.
However, what's been surprising and people didn't expect it is that once a person has drug-resistant TB, it can spread to others.
BIRTLES: If people are in this situation where they have multi-drug resistant TB, what can actually be done. Is it still treatable?
SPIGELMAN: It is treatable. The cure rates under the best of circumstances are in the order of about 60 per cent, but it requires a good two years of therapy, including which there are daily injections for usually six to nine months, usually four to five different different drugs, with pretty bad side affects. And at the end of that whole process, perhaps in a good system with good compliance, maybe 50 to 60 per cent of the patients are cured.
BIRTLES: In the Pacific, Papua New Guinea has the highest TB rates, with close to 15,000 new cases diagnosed every year.
Mel Spigelman says is will pose a challenge to Australian health authorities.
SPIGELMAN: Given the proximity of Papu New Guinea, given the fact that there is migration or that there is travel through the islands and into Northern Australia and given what a really difficult situation Papua New Guinea now has, that clearly is a situation that I think the Australian government and Australia needs to deal with in a very effective manner.
BIRTLES: The Australian government has committed tens-of-millions of dollars to TB programs in PNG.
Curt von Boguslawski is the Country Director for World Vision, one of several NGOs that carry out TB programs in Papua New Guinea.
He says education and treatment monitoring is being used to try and reduce the rates of multi drug-resistant forms of the disease.
VON BOGUSLAWSKI: It is a concern, but it's being addressed and it's really important that everybody understands that the main thing to address multi drug-resistant TB is actually to do quality direct observe treatment. The level of multi drug-resistant is manageable in the country.
BIRTLES: And he says work on the ground is helping to make inroads against the disease.
VON BOGUSLAWSKI: Now, we actually have detection rates which are up. We've had a couple of example, like in the Western Province, curious that treatment success rates have doubled within less than a year.
Source: ABC Radio Australia