• Abstract and Figures
• Public Full-text

Tuberculosis: Forgotten, But Far From Gone. FIGHTBACK TIMEBOMB DR. LEE REICHMAN SOUNDS OFF ON POLITICAL WILL, INNOVATION AND EMPOWERING PATIENTS . Are medical schools today focusing enough on TB? 5 Questions with ERS President-Elect Francesco Blasi UPDATES: PHILIPPINES STRENGTH IN NUMBERS ESTONIA THREE FRIENDS, FIGHTING MDR-TB TOGETHER PERU IN HOUSES, TB INFECTS ALL – INCLUDING THE CHILDREN TABLE OF CONTENTS 3 Contributors 4 Dr. Lee reiChman The Importance of Political Will in TB Control 6 5 Questions ABOUT TB ERS President Francesco Blasi 8 Phi LiPPines Strength in Numbers 32 ESTONIA Three Friends, Fighting MDR-TB Together 60 Peru In Houses, TB Infects All – Including the Children 86 TAn Ki G tb PersonaLLY Caregivers: The Frontline of TB Treatment A nurse outside Makati Medical Center in Manila, Philippines. LEADING THE WAY TOGETHER …we sought to offer portraits of hope that may be able to inspire those who are currently battling TB… We at Otsuka are extremely proud to backyard. Otsuka saw its Asian neighbors partner with the European Respiratory with limited access to new medicines Society (ERS) for the development of this available in the West left helplessly to die. project. Sometimes when confronting The company knew there was more that deadly infectious diseases there is a could be done to benefit their healthcare tendency to focus on the clinical aspects and that one new treatment option alone of fighting the illness and forget about the would not be enough to help the millions lives of individual patients. With this project, of people who were dying of TB every year. we sought to emphasize the very personal Thankfully, researchers at the time had the nature of TB – the individual struggles, vision and foresight to recognize TB is an successes, and stories of patients from three extremely tenacious pathogen that finds very different countries but all sharing in one new ways to attack the human body and common fight. Most importantly, we sought resists many forms of antibiotics. to offer portraits of hope that may be able to inspire those who are currently battling TB, Our efforts in TB are symbolic of Otsuka letting them know this is a curable disease as a whole. Adapting our approaches that can be overcome. to transitions in healthcare, we have made it Otsuka’s mission to address In 1971, Otsuka selected TB as one of its medical challenges through research and first research themes. TB remained a serious development that bring truly innovative threat, particularly in the company’s own solutions to patients worldwide. 1 Early morning rush hour in downtown Manila, Philippines. 2 CONTRIBUTORS Journalist John Donnelly and photographer Riccardo Venturi are no strangers to global health issues and TB. But working together on assignment for the first time, they were impressed to find strong TB programs at work, personally invested healthcare workers, and resilient patients with the will to live. John Donnelly is an award-winning writer based in Washington, D.C., who specializes in global health issues. For a decade, he worked for the Boston Globe, covering foreign affairs from Washington and global health and development issues based in South Africa. Prior to that, he was the Middle East correspondent for the Miami Herald. He is the author of A Twist of Faith, a book about the vast faith-based movement to help orphans in Africa. He also has written and produced books for Harvard University, the World Health Organization, Johns Hopkins University, Management Sciences for Health, and the Consultative Group for International Agricultural Research. Riccardo Venturi graduated from “Istituto Superiore di Fotografia” in Rome in 1989 and began his career documenting Italian and European social issues such as illegal immigration and the rise of Nazi movements in Germany, and the early years of democracy in Albania. In the mid 1990’s his attention was mainly drawn towards countries in conflict, foremost Afghanistan, winning the prestigious World Press Photo Prize in 1996. In 1997 he won the Leica Honorable Mention for his reporting of the war in Kosovo. Ever since, he has travelled to countless countries at war among them Somalia, the Gaza strip, Liberia, and Sierra Leone. Recently, Venturi has covered significant global events, such as the tsunami in Sri Lanka and the earthquake in Iran in 2003, alternating with personal investigations, such as a long-term project about the spread of tuberculosis throughout the world, realized in collaboration with the World Health Organization (WHO), winning in 2008 the “Marco Lucchetta” Award and the UCSI Award for Photography in 2009. Most recently, Venturi has been covering the earthquake in Haiti and its aftermath. With his project “Haiti Aftermath” Venturi received several awards such as: the World Press Photo, first prize General news; Luis Vultena Award, second prize; Sophot Award; Picture of the Year Award, honorable mention; Sony World Photography, finalist; Care International Award, finalist. Riccardo Venturi is represented by Contrasto photo agency since 2001. 3 THE IMPORTANCE OF POLITICAL WILL IN TB CONTROL By Dr. Lee Reichman When I was given the opportunity to We all agree that we need new tools: new diagnostics, participate in this project and visit Estonia I immediately drugs and vaccines. But while we wait for such new tools jumped at the chance to observe a program I had heard so to be introduced, are there other innovations in practice much about over the years and meet several patients face or theory that might be considered or reconsidered to to face. Estonia, like many other Eastern European and improve the situation? former Soviet countries, is burdened with a mind-boggling MDR-TB problem, caused by previously poor programs, What I observed in Estonia – dedicated professional staff, poor follow up, poor adherence, and lack of political will, innovative programs, and effective Directly Observed among other reasons. But what I found upon arriving in Treatment (DOT) not only putting a crimp into TB Estonia was truly eye opening: an unprecedented level of control, but possibly, MDR-TB rates as well – told me the communication between TB doctors, nurses, public health answer was unquestionably, yes. But the centerpiece is officials and government ministers. something called the TB Consilium – an ad-hoc group of professionals that together help manage all 303 TB Ten years ago in my “Timebomb” book I gave a cases1 throughout the country. They meet on a frequent dire warning of what could happen if public health basis – no less than monthly – and review each and authorities did not place greater emphasis on measures every pending case. They discuss challenges, needs, that prevented the spread of TB and particularly strategies, and most importantly, their activities and multidrug-resistant varieties of the disease. Yet in this recommendations are fully backed by the government. decade, little seems to have changed. 1 2010 figures 4 The first element of the World Health Organization’s Stop prevention today will yield dividends tomorrow. Countries TB Strategy is political will. This cannot be overemphasized cannot simply abandon course or re-adjust their thinking if as it is the lynchpin to all other aspects of TB control which there is not a sharp decline in a graph or chart by next year. include case detection, directly observed therapy with Tackling TB just doesn’t work like this. It requires a long- case management, reliable drug supply, recording and term vision and a long-term approach. reporting. And all this is exactly what is seen in Estonia, quietly and effectively. Excitingly, the focus we are beginning to see on political will is intersecting at the same time new TB tools and Not just in Estonia, but in the other countries explored innovations are hitting the scene. These innovations didn’t in this magazine we see the importance of political will happen overnight either – they took time to develop and resurfacing time and again. In the Philippines, a strong research, some over a span of decades or more. movement on the part of the Ministry of Health and the National TB Program (NTP) has gradually moved to And of course, good tools are only half the equation: it decentralize services across the 7,107 island nation so that is the way they are implemented and used that makes patients in rural communities can gain access to the same all the difference. This must be done at the local level, level of care rather than having to go great distances to making the importance of community-based care equally cities for treatment or seek hospitalization which can often important. One of the reasons the HIV community has been increase infection risk and drug-resistance. The move to so successful advancing their agenda is because they have decentralization in the Philippines will take time, but the been remarkable at empowering the patients themselves. NTP has a multi-step plan in place and is on-track to meet The same must be done in TB. Reducing hospitalization so their millennium challenge goals. that patients can be treated in their local towns and villages means they can remain a vibrant part of the community In Peru, the level of political will rises all the way to the top, and not treated like social pariahs. Like those I saw in with President Ollanta Humala making it clear, for the first Estonia, if patients everywhere had the opportunity to stay time that I can remember in any country, that fighting TB with their families, work a job or go to school once they is a top priority of his presidency. He has organized various are no longer infectious, we could dramatically reduce the levels within all ministries –from Health to Transportation - stigma associated with the disease.

Load more

  96

Copy Link