China: Hard-to-Cure TB Poses New Global Health Threat

On April 1, health ministers from countries among those worst-hit by TB will gather in Beijing for a World Health Organization conference to plan how best to battle the disease over the next five years. In 2007, an estimated half-million people were infected with multidrug-resistant TB (MDR-TB), and 55 countries and territories had reported extensively drug-resistant TB (XDR-TB) at the end of 2008, WHO said last week.

Drug-resistant TB is fueled by health care systems that cannot keep track of TB patients; patients who do not adhere to a full course of antibiotics; and improper treatment.

In India, rural health care is often poor and there is little control of TB drug access. In Russia, the health system lacks qualified medical staff and drugs. In South Africa, TB thrives among the many people whose immune systems are compromised by HIV/AIDS. Nearly a quarter of MDR-TB patients worldwide live in China, and most are not receiving proper treatment, which is very costly. In the United States, drug-resistant TB is a problem for states with large immigrant communities, because many people come from or travel frequently to areas where TB is endemic.

International experts recommend that TB treatment centers closely monitor patients and directly observe TB treatment. However, most facilities in China lack the funds to track every patient. In addition, many of the 130 million migrant laborers from rural China do not qualify for the free TB treatment given to urban residents.

In the past decade, China has made marked progress in its TB fight. An Internet-based reporting system helps health officials channel TB patients to local treatment facilities run by the communicable-diseases agency. More than 90 percent of new infections are cured, the Health Ministry reports. And though it did not specify a rollout date, the ministry says it is working on a plan to treat the 112,000 people that WHO estimates have drug-resistant TB in China.

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