Lancet Examines Call to Action on TB Control Developed at Beijing Meeting
The Lancet on Saturday examined "The Beijing Call for Action on Tuberculosis Control and Patient Care," which was developed earlier this month by health officials from 27 countries with high burdens of multi-drug and extensively drug-resistant tuberculosis during the Ministerial Meeting of High M/XDR-TB Burden Countries in Beijing. According to the Lancet, the plan features 13 action points, calling in part for universal access to TB diagnostic and treatment services, ministerial collaboration, guaranteed TB drug supply and increased TB advocacy.
The countries also pledged to help mobilize efforts to secure the estimated $2 billion needed over the next two years to finance MDR- and XDR-TB prevention and treatment initiatives. Each country contributed to the plan by developing an MDR-TB strategy, which included needs, budgets, policy factors and resource mobilization. According to the Lancet, the officials plan to meet again in October in Geneva to present their plans and report progress toward meeting their targets.
According to the call to action, increased rates of drug-resistant TB could result from "insufficient and late case detection." Presenters at the meeting indicated that unsupervised distribution of over-the-counter drugs to treat TB also might contribute to the increase in MDR-TB prevalence. According to the Lancet, the private sector provides about 90% of TB drugs in countries such as India and the Philippines. Tido von Schoen-Angerer, director of Medecins Sans Frontieres' Campaign for Access to Essential Medicines, said, "The call for action says a lot of good things." He added that participating countries need a TB framework that outlines a "clear role" for the World Health Organization, similar to the Framework Convention on Tobacco Control.
According to the Lancet, some countries with the highest TB burdens -- such as China and India -- allocate proportionally the least money for prevention and treatment efforts. "Most cases are in Asia but only a small fraction of the funding is in Asia," Katherine Floyd of WHO's Stop TB Department said. Chinese Health Minister Chen Zhu during the meeting presented the results of a recent cross-sectional survey of 47 million people in 31 Chinese provinces, which identified 30,000 TB cases. Of these, 8.32% were MDR-TB and 0.68% were XDR-TB. In addition, 80% of the drug-resistant TB cases occurred among rural populations and the strain primarily affected "young to middle-aged people," Chen said. According to a representative for India's health minister, India has reported XDR-TB cases "but the extent and magnitude have yet to be documented" (Harris Cheng, Lancet, 4/18).
The call to action is available online.