Half a million TB patients in Pakistan

Gaps in reporting, coverage and funding remain, warns WHO

Over half a million people were estimated to be sickened with tuberculosis in Pakistan in 2015, a new report said on Thursday.

The country had a large gap in the number of cases and those reported and in funding to address the disease.

The World Health Organisation’s Global TB Report 2016, estimated that there were 510,000 people afflicted with the disease in the country last year with 270 out of 100,000 people affected. However, the country only notified 331,809 cases, a gap of around 200,000.

Further the report said that the total number of new and relapse cases in the country stood at 323,856.

Despite coming in the six countries with the highest incidence of cases, Pakistan had a substantial reduction in mortality from over 75 per cent in 2000 to just 24 per cent in 2015 when 46,000 people died from the disease.

While monitoring treatment of the disease in Pakistan, the report said there was 63 per cent of treatment coverage in the country. Worryingly, the report had found high levels of  Ofloxacin resistance in the country. There were 26,000 multi-drug resistant TB (MDR-TB)cases reported in the country last year.

The report said that Pakistan was currently undertaking a second inventory study focussing on children with tuberculosis.

To improve detection of the disease, the report said that international non-governmental organisations in the country had developed methods breaking away from traditional ones to detect the disease including active screening for the disease at private clinics, private hospitals and laboratories. Access was also provided to new rapid diagnostic tests at subsidised or even free for patients at private clinics.

Citing an example, the report stated that screening at private clinics in Karachi helped doubled the number of case notifications from the city in a year.

Funding restraints

The report said that Pakistan had an annual budget for its national strategic plan against tuberculosis of just $62 million. Of this, however, only one per cent, or $410,000, was provided by the government. The remaining funds were provided by international donors.

However, this was still short of the $69 million which the country needed to adequately combat the disease.

Global incidence

The global tuberculosis epidemic is larger than previously thought, infecting 10.4 million people last year, while research into vaccines and cures is “severely underfunded,” the WHO warned.

This was in contrast to last year’s report by the UN health agency which said 9.6 million people were sickened with TB worldwide.

Deaths also rose across the planet, with 1.8 million people dying of TB last year, 300,000 more than a year earlier, according to the WHO’s Global TB Report 2016. “We face an uphill battle to reach the global targets for tuberculosis,” said Margaret Chan, WHO Director General.

“There must be a massive scale-up of efforts, or countries will continue to run behind this deadly epidemic and these ambitious goals will be missed.”

Two out of five people who fell sick with the disease -- caused by a bacteria that infects the lungs and makes people cough up blood -- went undiagnosed and untreated.

Published in The Express Tribune, October 14^th, 2016.