Asian countries at the forefront of the global fight against tuberculosis

Tue, Oct 16, 2012, 01:00

While China has succeeded in lowering fatalities, India struggles with outbreaks, writes CLIFFORD COONANin Beijing

THOUSANDS OF Chinese people with TB, or their relatives, seeking help dealing with the illness, are turning to a blog by a 21-year-old Beijing-based university graduate, Wei, who describes the challenges of negotiating an overstretched medical system and the fear he felt when he became ill.

“I am no longer an ordinary person, I am a person with tuberculosis. No one understands the bitterness, just as day does not understand night,” he wrote this year in his touching blog.

While his thoughts make for occasionally grim reading, they also describe how the disease is cured, and his message is a hopeful one. As the World Health Organisation tells us in its guidelines, tuberculosis is spread from person to person through the air. When people with lung TB cough or sneeze or spit, they propel the germs into the air, and a person needs to inhale only a few of these germs to become infected.

Asia, the world’s most populated, and most densely populated, continent, was always going to be a prime breeding ground for TB.

India and China together have nearly 40 per cent of the world’s TB cases.

India’s situation is acute. It accounts for 21 per cent of the world’s TB cases, with 1.98 million people developing TB and nearly 300,000 dying every year.

Wei’s story tallies with the broader picture in China, and it is significant how even the world’s most populous country, China, can make progress in stopping deaths from TB.

Between 1990 and 2010, China’s TB death rate fell 80 per cent, from 216,000 in 1990, to 55,000 in 2010, and the number of people ill with TB dropped by half, according to the World Health Organisation.

Wei tells how how he felt sick, out of breath and had no energy in December last year, and in January he went to the military hospital.

China is the biggest of the 22 countries that have shown a sustained decline in TB cases over the past 20 years, and has made dramatic progress in TB control.

However, the medical system is hugely overstretched, and Wei had to deal with the usual problems. Without knowing the right people in the hospital, without having gifts to offer the doctor, he had to wait a long time for the test results.

When they came, he was diagnosed with tubercular pleurisy.

“I have never thought I would get TB. Still, during treatment, I have nothing to do, so I want to write down my experiences to share with you,” Wei wrote on his page on the Baidu Bars bulletin board.

His classmates came to visit him, and he tried to develop the courage to defeat the “evil devil of sickness.”

He was then discharged from hospital. His parents picked up his things and he went home.

“One day I got a fever of 39.5. My parents were worried, so I went to the military hospital again in March,” he wrote.

The doctor eventually moved him to a hospital specialising in pulmonary diseases. It was located near a vineyard, close to the Guanting reservoir, about 100km from Beijing.

The attending doctor, a friend of Wei’s parents, was furious at how Wei had been treated at the military hospital, saying he had been given doses of medicine which were too weak. He said Wei had pulmonary TB and set about making him better.

At the new hospital, they upped the dosages of drugs and he felt better, gaining a few kilos. They stopped Wei using the internet to research about TB, and told him to focus on getting better.

“When I first got sick my mood was very bad. I was afraid I wouldn’t live to see tomorrow. By April, I was released from hospital. My joints are painful, all the effects of the medicine. But my tests are better,” said Wei.

He stayed at home to recuperate, wrote his blog to encourage other TB sufferers online, and went to the doctor whenever he felt nervous. In June, he was able to go back to work, and moved out of Beijing because the air was too dry; Anhui has damp air, which is good for the lungs.

As well as government efforts to control the disease, the Gates Foundation, a fund set up by Microsoft founder Bill Gates, spends millions of euro every year on tests of new treatments for tuberculosis patients in China.

For example, diagnosing MDR-TB (Multidrug-resistant TB) and HIV-associated TB can be complex, but it has rolled out a two-hour test that has proven highly effective in diagnosing TB and the presence of drug resistance.

“Through our advocacy work in China, MDR-TB has been classified as a ‘highly reimbursable disease’ under the country’s health insurance schemes, which means that Chinese patients with this condition will be more likely to receive financial assistance in paying for their treatment,” the foundation wrote in a research document.