The clock is ticking

Author: Dr Syed Hussain Hadi

March 24 is commemorated as the World Tuberculosis (TB) Day the world over. The day reminds the world that TB remains a threat for most of the world despite of the fact that it is a curable disease. The day is, in fact, a tribute to medical scientist Robert Kocks, who on this day in 1882 announced discovering Tuberculosis causing organism Mycobacterium Tuberculosis. Tuberculosis is an ancient infectious disease which affects the people across the world. Worldwide, TB is the leading infectious disease killer and one of the top 10 causes of death overall. The day aims at increasing awareness among the communities that tuberculosis, which is 100% curable and the treatment of 100% free.

In 2019, about 10 million people developed TB and caused 1.4 million deaths globally.

In Pakistan it is responsible for 570,000 suffering of the TB & 42000 deaths in 2019 alone. Three out of four patients in the economically productive age group 15-45 years. The prevalence in older age groups is highest. Anybody can suffer for TB but by and large it is a disease of poverty and affects those who are most marginalized.

The main symptoms of the disease are: coughing more than two weeks, coughing up blood, experiencing night sweats, feeling weak and tired and losing weight.

TB transmits to other people when a TB patient coughs and sneezes and the air having TB bacterium is inhaled by a healthy person. The TB does not spread through casual contact, like passing by a patient on the street, by sharing utensils or food, cigarettes, shaking hands or having sex.

Also, 90 percent of the people do not develop TB if TB bacterium enters their body. The strong immunity keeps them safe. Only 10 percent suffer TB disease because of their compromised immunity due to any reason like poor nutrition, anti-cancer therapy and people on steroids. TB can affect any part of the body but most commonly affects the lungs which is called Pulmonary TB.

In September 2018, the global community came together to discuss TB elimination and Sustainable Development Goals (SDGs). In September 2018 and United Nations General Assembly, high level meeting we have committed to be a global partner to treat a portion 40 Million TB patient and put 30 million on preventive treatment by year 2022.

National TB Control program with the support of provincial governments, private organizations, and international partners is making all efforts to control this menace. The most important supporter in this regard is the The Global Fund. With the support of Global Fund and WHO around 1,500 laboratories, 5,000 treatment sites and 8000 selected private clinics have been established where FREE of cost diagnostic and treatment facilities are provided. The overall objective of the of the program is to reduce mortality, morbidity and disease transmission so that TB is no longer a public health problem. The NTP, Ministry of National Health Services Regulations & Coordination developed a comprehensive strategy under the National Strategic Plan for TB control in the country.

Despite of the all the efforts of the government of Pakistan and the partners, there are still challenges to achieve the goal of a TB free Pakistan; poor literacy rate, social stigma, poverty, lack of health education, large unregulated private sector and limited investment through domestic resources. There is urgent need to implement Mandatory TB Case notification which has been passed by the provincial legislative assemblies & design long terms sustainable program. TB control should not be limited to health only and all other sector which can contribute should come forward for this priority disease control. The Multi-sectoral collaboration is needed and I urge that Nutrition, education, agriculture, social welfare, BISP, and Sehat Insaf and most importantly media has a pivotal role and must be engaged in a meaningful way and TB should be perceived as a social issue and not merely a disease.

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