Tuberculosis (TB) is a highly prevalence infectious disease caused by Mycobacterium tuberculosis (MTB). The WHO recently estimated that one third of the world population is infected with TB and that 13.7million people worldwide have active TB. Africa is facing the worst tuberculosis epidemic since the advent of antibiotic era. This is driven by a generalized human immunodeficiency virus (HIV) epidemic and compounded by weak health care system, inadequate laboratories and conditions that promote transmition of infection. This devastating situation has contributed to the emergence of drugs resistance strain of tuberculosis.
WHO estimates that the incidence of TB in African countries has doubled from 149 to 343 per 100,000 population between 1990 and 2005. The increase in TB prevalence in African regions is attributable to several factors, the most important of which is HIV epidemic. Although HIV is the leading cause of death in Africa, TB is the most common co-existing condition in people who die from AIDS.
Long term therapy of TB consist of four drugs (Isoniazid, Rifampicin, ethambutol and Pyrazinamide) which are administered for 2months initial phase, followed by two drugs (Isoniazid, Rifampicin) which are used in combination for 4months continuous phase. In recent years, the number of new drugs approved for treating TB has not increase proportionally to the investment in the field. Although these regimen has reduced mortality rate worldwide, the emergence of multidrug resistance TB (MDR-TB), extensively drug resistance TB (XDR-TB), TB/HIV co-infection are challenges that needs to be overcome.
TB among other diseases is still claiming an unacceptably millions of lives in developing countries which is compounded by weak political commitment with adequate and sustained financing, poor access to adequate health facilities and lack of adequate system to fight against the disease and ensure that drugs and vaccines are made available to those who need them.
KNCV tuberculosis foundation shares in the outrage expressed by the stakeholders in tuberculosis community regarding the exclusion of TB from the recently published WHO list of antibiotic resistant ‘priority pathogens’. WHO responded that addressing drug resistant TB is a top priority given the global consensus that TB treatment is already a top priority for R&D. KNCV welcomes this clarification and is keen to see an accelerated action following the global ministerial conference on TB in Moscow in November this year and hope that this event and other platform for collaboration and effective partnership will have significant impact in ending TB epidemic.
I had the privilege of working in a community pharmacy and I was able to record not fewer than two cases in which patients walk into the pharmacy to make request for rifampicin in order to treat urinary tract infection. Curiously I often ask them “why rifampicin” but their justification is overwhelming. Through my interaction with them I came to discover that it is a chain of recommendation. There is need to fortify community awareness about global tuberculosis (TB) epidemic and efforts to eliminate the disease. There is a need to further strengthen investment in preventing antimicrobial resistance (AMR) and the development new and efficacious drugs for the treatment of drug resistant TB and put an end to the needless suffering incurred by communities, families and patients.