WHO warns apocolyptic TB disaster possible

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WHO warns TB disaster possible without action 8 Nov 2007

CAPE TOWN, Nov 8 (Reuters) - The world is at risk of a tuberculosis

crisis if killer drug-resistant strains of the disease are not

contained, a senior World Health Organisation official warned on Thursday.

" Scenarios of apocalyptic nature are not, let's say, likely, but they

might happen. They are not... impossible, " said Raviglione,

director of the World Health Organisation's Stop TB department.

" Globally speaking about 96 percent of all TB cases are still

treatable with the four drugs that we use in the standard regimen, 4

percent are multi-drug resistant ... but the worst case scenario is

when this 4 percent becomes 50, 60, 70, 80 percent, " he told reporters

at a conference in Cape Town.

Raviglione said a worst case scenario would see multi- and extensively

drug resistant TB overtake cases of ordinary TB, which can still be

cured with older but effective drugs.

Multi- and extensively drug-resistant TB (MDR-TB and XDR-TB) are

mutations of common TB virtually immune to all treatments. Raviglione

said some countries in the former Soviet Union were showing an MDR-TB

incidence of up to 20 percent, while some European states showed

resistance to all second-line TB drugs -- the most powerful in an

increasingly ineffective drug arsenal.

Outlining the seriousness of the emerging drug resistance, Raviglione

said the situation in some European countries reminded health

officials of the " pre-antibiotic era " of 1943.

He said Russia, China, India and South Africa were the four countries

worst-hit with MDR-TB and XDR-TB, accounting for up to 60 percent of

the world's cases.

The emergence of drug-resistant TB strains, coupled with a deadly

co-infection of TB and HIV, has alarmed health authorities who are

uniting to head off a global TB crisis.

On Thursday, hundreds of activists and TB experts attending the 38th

Union World Conference on Lung Health marched through Cape Town's city

centre to draw attention to the disease, easily spread during close

personal contact.

Experts agree that underfunding, outdated drugs, a lack of new

vaccines and poor diagnostics for TB are hampering treatment, leading

to higher and faster mortality rates, especially among those infected

with both TB and HIV.

" The XDR epidemic has simply exposed the limitations of the current

tools used to control TB ... New diagnostics and hopefully a new

vaccine are fundamental items that we have to push through as a global

community, " Raviglione said. (Reporting by Wendell Roelf; Editing by

Winfrey)

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