Halting the world’s top infectious killer
Every year, 10 million people fall ill with tuberculosis (TB). Despite being a preventable and curable disease, 1.5 million people die from TB each year — making it the world’s top infectious killer, according to the World Health Organization (WHO). The Philippines ranks fourth worldwide in tuberculosis (TB) incidence and is thus considered a high TB burden country. About 2 million Filipinos have TB, half of whom have the active disease. Sadly, nearly 85 Filipinos die every day from this disease.
TB is caused by Mycobacterium tuberculosis, a type of bacteria that usually attacks the lungs but can attack any part of the body such as the kidney, spine, and brain. Not everyone infected with the TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection (where the patient is infected with the TB bacteria but not ill) and active TB disease. If not treated properly, active TB disease can be fatal, according to the US Centers for Disease Control and Prevention (CDC).
Active TB disease in the lungs may cause symptoms such as a bad cough that lasts three weeks or longer, pain in the chest, and coughing up blood or sputum (phlegm from deep inside the lungs). Other symptoms of active TB disease are weakness or fatigue, weight loss, loss of appetite, chills, fever, and sweating at night. TB bacteria spread through the air from one person to another, the CDC stated. When a person with active TB disease coughs, speaks, or sings, the TB bacteria get airborne, and people nearby may breathe in these bacteria and thus become infected.
Active TB disease is curable with a standard six-month treatment course of four antibiotics, which usually include rifampicin and isoniazid. In patients with drug-resistant TB, the TB bacteria does not respond to the standard drugs. Treatment for drug-resistant TB is longer and more complex.
The TB treatment course is provided to the patient with information, supervision, and support by a health worker or trained volunteer. Without such support, treatment adherence can be difficult. If the treatment is not properly completed, the disease can become drug-resistant and can spread. For patients with latent TB infection, preventive treatment can be given to stop the onset of disease. This treatment uses the same drugs for a shorter time. Recent treatment options have shortened treatment duration to only one or three months, as compared to six months in the past, said the WHO.
March 24 of every year is World TB Day. This annual event commemorates the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis. This year’s theme, “Yes! We can end TB!,” conveys a message of hope that getting back on track to turn the tide against the TB epidemic is possible through high-level leadership, increased investments, and faster uptake of new WHO recommendations. Efforts now shift to turning the commitments made by Heads of State at the UN High Level meeting in 2023 to accelerate progress to end TB into tangible actions. The most important of these commitments is ensuring that by 2027 at least 90% of those who develop tuberculosis are treated and at least 90% of those at risk of the disease are provided with preventive treatment.
Member States also agreed to roll out WHO-recommended rapid molecular tests. Over half of TB diagnoses are still made using microscope and clinical examination. Other targets include increasing global funding for TB to $22 billion by 2027, almost four times the $5.8 billion spent in 2022. A target of $5 billion by 2027 was assigned for research and innovation spending, which stood at $1 billion in 2022.
The National Tuberculosis Control Program (NTP) of the Department of Health (DoH) works closely with all stakeholders — National Government agencies, public and private sectors, nongovernmental organizations, professional societies, academe, patient groups, civil societies, and development partners — in the country’s fight against TB.
The NTP adopts a multistakeholder approach in addressing the complex TB problem. It collaborates with nongovernmental organizations, such as the Philippine Coalition Against TB (PhilCAT), a consortium of 60 groups, and the Philippine TB Society, Inc., among many others. Various developmental partners and their projects provide technical and financial support to the NTP, such as the WHO, United States Agency for International Development (USAID), the Global Fund Against AIDS, TB and Malaria, the Research Institute of TB/Japan Anti-TB Association, the Korean Foundation for International Health, the Korean International Cooperation Agency, and the KNCV Tuberculosis Foundation.
During the Asia Pacific Symposium on Tropical Diseases held in South Korea last February, the government of the Republic of Korea offered the DoH a grant of 30 innovation machines to support the NTP. The Korean Heart to Heart Foundation, Research Investment for Global Health Technology (RIGHT) Foundation, and Foundation for Innovative New Diagnostics (FIND) also expressed their intent to include the Philippines in the trial run of these new machines for diseases such as TB, dengue, and malaria.
The biopharmaceutical industry fully supports the NTP and is committed to working with all stakeholders to expand access to TB diagnosis, care, and treatment as well as to strengthen the country’s healthcare system. All sectors are needed to advance therapies and move health systems towards universal healthcare so that all individuals and communities receive the health services they need without suffering financial hardship. ■