High-level Ministerial meeting on drug-resistant tuberculosis in Beijing

High-level Ministerial meeting on drug-resistant tuberculosis in Beijing

The High Level Ministerial Meeting on multi- and extensively- drug resistant TB (M/XDR-TB) will be held in Beijing from 1 to 3 April 2009 and is being organized by the World Health Organization (WHO), the Ministry of Health of the People's Republic of China and the Bill and Melinda Gates Foundation.

This meeting is likely to bring together health ministers and other stakeholders from 27 high M/XDR-TB burdened countries, including justice and science ministry delegations and representatives from international agencies, civil society, research communities and the corporate sector.

"We have been able to convince the ministers of health of 27 high burden M/XDR-TB countries to come to the Beijing meeting and commit to achieve the targets of the Global Plan to Stop TB" said Dr Ernesto Jaramillo, Medical Officer, Stop TB Department, World Health Organization (WHO) at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil.

"The 2nd Global Plan to Stop TB which was launched in 2006 had laid out specific targets for MDR-TB, to provide universal access to diagnosis and treatment of MDR-TB by year 2015" said Dr Jaramillo.

"Only 3% of people who have MDR-TB have access to effective treatment. We have compelling evidence that we know how to prevent and treat MDR-TB and treatment success rate is 80% in low resource setting. Its intervention is complex but is effective, feasible and is cost-effective" stressed Dr Jaramillo.

The 27 countries represented will be Armenia, Azerbaijan, Bangladesh, Belarus, Bulgaria, China, the Democratic Republic of Congo, Estonia, Ethiopia, Georgia, India, Indonesia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, the Republic of Moldova, Myanmar, Nigeria, the Philippines, the Russian Federation, Pakistan, South Africa, Tajikistan, Ukraine, Uzbekistan and Viet Nam.

The highest levels of MDR-TB ever recorded were reported by WHO in its 'Anti-tuberculosis Drug Resistance in the World' report in February 2008 with nearly half a million new MDR-TB cases emerging worldwide. According to the new WHO report (Global Tuberculosis Control report 2009), the levels of multi-drug resistant TB might be more than half a million as previously thought.

The threat of MDR-TB and XDR-TB can be halted but few of the 27 high MDR-TB burdened countries have response plans in place. Many of these countries are not even properly equipped to diagnose drug-resistant TB.

"We need political commitment from the countries. The XDR-TB task force had met in April 2008 in order to assess the progress we had made in response to MDR-TB and XDR-TB. The Task Force came up with lot of positive things, major progress in many areas. However the number of people on treatment was far below the target. One of the clear recommendations coming out of the XDR-TB Task Force meeting was to convene a high level ministerial meeting where we can get ministers of countries responsible for the 85% of the global M/XDR-TB burden, to achieve the target of universal access to diagnosis and treatment of MDR-TB by 2015" explained Dr Jaramillo.

Countries with low resources are building their capacities to make things happen. Lesotho was able to make a state-of-the-art laboratory for diagnosis of MDR-TB in six months. "We have countries like Nepal, Philippines, Peru that despite of weakness in health systems are providing universal access to MDR-TB diagnosis and treatment" said Dr Jaramillo.

"So far the Green Light Committee (GLC) mechanism, which is an initiative of WHO, and has played an instrumental role in leading the response, began with only one country in the year 2000 - Philippines. Now 8 years later we have 58 countries that have 116 projects approved by GLC. However we have less than 20% of countries that are moving towards scale up country wide of these interventions" said Dr Jaramillo.

Dr Jaramillo expressed his concern that "Countries are not moving fast enough in order to prevent the death of 1000 people with MDR-TB every day."

Vice Premier of China, the Director-General of WHO and very likely that Bill Gates and ministers of health confirmed so far from 21 high burden M/XDR-TB countries will be taking part in the Beijing meeting opening next week.

"We are expecting that this will be a watershed meeting in response to M/XDR-TB" said Dr Jaramillo.

"After this meeting we will like to move towards a World Health Assembly (WHA) resolution. The resolution of WHA is powerful in the sense that countries really commit to do things. After the Beijing meeting, one month later, the Government of China has agreed to submit a proposal of a resolution to the WHA in order to accelerate the response to M/XDR-TB" shared Dr Jaramillo.

The aims of the WHO high-level ministerial meeting on M/XDR-TB include:

- Strengthening political commitment and boosting engagement among affected countries and the global community.
- Using the months leading up to April 2009 to support countries to develop costed MDR-TB components of TB control within health sector plans.
- Working towards solutions in areas such as:
* anti-TB drug quality, supply and rational use;
* laboratory capacity and fast adoption of new and rapid diagnostic tools;
* involvement of the private sector in MDR-TB prevention and control;
* prevention of transmission of TB in healthcare facilities (infection control), congregate settings, prisons and communities;
* promotion of patient and community rights and responsibilites (The Patients' Charter for Tuberculosis care);
* research and development of new drugs and diagnostics.