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Global XDR TB - An
'Untreatable, Unstoppable Calamity'

By Adriana Stuijt

SEATTLE, WASHINGTON -- The Seattle Times in the USA has published an editorial -- co-authored by United States Democratic congressman Adam Smith (of Tacoma), a co-sponsor of the Stop TB Now Act of 2007; as well as by Dr. David R. Park and Dr. James K. O'Brien, co- chairmen of the Washington State TB Advisory Council -- warning that: "unless steps are taken now to strengthen (TB) control efforts at home (in the USA); in Africa and throughout the world, these deadly Extremely-Drug-Resistant Tuberculosis strains will continue to spread and multiply. The resulting global XDR-TB epidemic will be an untreatable and unstoppable calamity."
'XDR-TB ... the public health crisis of 2007'
Congressman Smith, Drs. Park and O'Brien warn in their editorial that in South Africa, 100 patients had recently fled a hospital after paramedics wearing head-to-toe protection brought in eight people with the same contagious infection.
"This very real and very lethal disease is the same disease that has made headline news recently - it is a new form of tuberculosis called "extensively drug-resistant TB," or XDR-TB," they write.
"No one is safe from XDR-TB. As if to highlight the point, the widely publicized travels of (Atlanta attorney) Andrew Speaker remind us all that exposure to tuberculosis, and XDR-TB, can occur anywhere and at any time.Just recently, King County (i.e. Seattle) reported that TB cases have doubled in the county compared with the same period last year. And while extremely drug-resistant TB hasn't arrived here yet, it is shaping up to be the public health crisis of 2007...." they warned.
XDR-TB is shaping up to be the public health crisis of 2007...
"The deadly strain has been identified in 28 countries on five continents. It kills almost everyone it touches (up to 85 percent) with remarkable speed. In the first large outbreak in South Africa, 52 of 53 patients died within 14 days of diagnosis (in October 2006).
"The (grossly-understated) official SA death rate thus far this year is 600 people - in all of the country's provinces. And while Extremely drug-resistant TB hasn't arrived here in Seattle yet, it is shaping up to be the public health crisis of 2007," they warned.
"Most people with the latent form will never experience symptoms, but TB thrives in those with weakened immune systems. The combination of TB and HIV/AIDS in sub-Saharan Africa is particularly explosive. TB is the biggest killer of people with AIDS. But while international attention has focused on preventing and treating HIV/AIDS, inadequate funding for TB control has allowed the disease to grow unchecked and mutate into frightening forms," they also warned.
* (Note by Adriana Stuijt -- In South Africa, 61 percent of the more than 250,000 people diagnosed each year (and rapidly dying of ) Tuberculosis each year are also co-infected with the human- immune deficiency virus which leads to Aids and thus become untreatable with any known medicines, i.e. such patients rapidly die of XDR-TB. Since the year 2000, World Health Organisation records also show, at least 2,6-million South Africans have already died of this uncurable TB+Aids coinfection, according to Dr De Cock, head of the HIV-Aids department of the World Health Organisation in Geneve, Switserland.)
Seattle... struggles to treat the growing number of TB-infected people here...
The Seattle editorial continues that funding for elimination of (TB) in the U.S. has plummeted so low that the Centers for Disease Control can no longer fulfill its mandated task to eliminate the disease. Meanwhile, King County (Seattle, Washington State) is struggling to screen and treat the growing number of infected people here".
"... our inability to protect our population against this deadly strain..."
They quote Dr Paul Nunn, the World Health Organisation's coordinator of HIV- and drug-resistant tuberculosis programs, as saying: "It is here, it is really scary, and it is an emergency." They also noted that the U.S. Centers for Disease Control's Advisory Council for the Elimination of Tuberculosis has warned that "unless we take immediate measures, we as a nation will be forced to confront the inability to protect our population against this deadly strain."
"Unless steps are taken now to strengthen control efforts at home, in Africa and throughout the world, these deadly strains will continue to spread and multiply. The resulting global XDR-TB epidemic will be an untreatable and unstoppable calamity.
Start funding solutions...
"It's time for the world - including the U.S. - to stop manufacturing dangerous forms of TB and to start funding solutions. The "Stop TB Now Act of 2007" aims to do just that by supporting the Global Plan to Stop TB 2006 - 2015. If funded and implemented, the plan will cut TB deaths in half by 2015 and ultimately eliminate TB as a global health problem by 2050. Through the Stop TB Now Act, the U.S. would help to create the first new TB fighting drugs in nearly 50 years, the first new diagnostic test in over 100 years, and the very first effective vaccine," the writers concluded.
No XDR-TB cases in Botswana thus far... health ministry
June 13 2007 -- Botswana's Health Minister Professor Sheila Tlou said the World Health Organisation would 'strengthen its support to countries mostly affected by multi-drug resistant and Extensively Drug-Resistant (XDR) TB while also supporting, in terms of personnel and research, for those affected by a combination of HIV and TB." She was giving feedback to the news media on her return from Geneva for the World Health Organsiation's assembly meeting last Friday.
Botswana's deputy permanent secretary (health services) Dr Loeto Mazhani also noted that there is still no laboratory evidence of patients with Extremely-drug-resistant tuberculosis (XDR TB) in Botswana. He however said that they were still awaiting results of a survey for tests they had sent to South Africa. "We have never had to isolate anyone," he said.
South Africa's health minister quotes 2006 statistics in parliament:
From South Africa, journalist Wyndham Hartley also reports from Cape Town that South Africa's health minister Manto Tshabalala- Msimang has finally broken her public silence about XDR-TB -- but quoted old health department data from the year 2006 when replying to a parliamentary question. Up to the end of 2006, at least 403 XDR-TB cases had been officially identified and of these about 265 had died, she claimed. And there even were 135 patients still undergoing treatment, she added.
The South African government is being widely accused by top TB-Aids experts of being far too slow to respond to the threat of extremely drug-resistant tuberculosis (XDR-TB) since its fourth outbreak since 2003 occurred in the country in October 2006. While the first three outbreaks were contained inside the confines of TB-hospitals in the country -- the latest outbreak has now gone out of control from KwaZulu-Natal province, and is now found in all nine provinces of the country.
The South African health minister continued to quote old statistics in her reply to a written parliamentary question from Inkatha Freedom Party MP Ruth Rabinowitz., admitting for the first time however that XDR-TB has now been identified in all nine provinces of South Africa -- and claiming that these patients now were 'under treatment".
She also mentioned with considerable acrimony that "about 13 patients in Gauteng were being 'held against their will' in (Sizwe hospital for tropical diseases in Rietfontein) hospital."
Her official health policy regarding such 'forced incarceration of XDR-TB patients" is explained on the following video:



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