MSF: TB control in Turkmenistan

Press release, March 24, International TB Day - Owing to a lack of awareness about tuberculosis, a lack of global political commitment and poorly managed medical programmes throughout the world, tuberculosis is causing more preventable deaths today than any other infectious disease despite the fact that there is an internationally accepted cure, DOTS (Directly Observed Treatment Short Course). To meet the need for better DOTS programmes and TB control in the Dashoguz Velayat - where the incidence of TB is the worst in all of Turkmenistan - MSF today, in conjunction with the Ministry of Health and Medical Industry in Turkmenistan, officially launches its 'DOTS FOR ALL' strategy. The strategy will lead to the complete coverage of Dashoguz Velayat area in DOTS TB control. MSF has been supporting the Ministry of Health and Medical Industry to implement pilot tuberculosis control projects in Kunya-Urgench and Turkmenbashi etraps since May 1999 by supplying medical drugs, equipment and materials free of charge and providing DOTS training for medical personnel. DOTS, the TB treatment protocol recommended by the World Health Organization, is already being used in over 102 countries worldwide and has proven to be effective, efficient and cost effective in treating new cases of tuberculosis. Although new cases of TB are completely curable, large numbers of people continue to become ill and die from the disease. Many cases remain undiagnosed due to a lack of awareness on the part of the patient and health staff. It is estimated that less than half of TB patients worldwide, are detected by the health care system. Moreover, many patients, after having started on treatment, do not complete their course of medicines. This contributes to multidrug-resistant tuberculosis (MDR-TB) which is very difficult to treat and for which, treatment costs, between $US 5 000 and $US 8 000 per patient. This compares to the inexpensive treatment costs of $US 40 for one case of drug sensitive tuberculosis. In 1999, MSF launched an 'International Campaign for Access to Essential Medicines.' Over the years MSF has realised that increasingly there are fewer and fewer effective drugs being developed for dealing with tropical and infectious diseases. In addition, the costs of certain drugs - due to international trade barriers are prohibitively expensive, even when they are available. Considering the extent of the TB problem in the Aral Sea Area, with possible high rates of multi-drug resistance, this campaign is crucial for Turkmenistan. MSF, the recent winner of the Nobel Peace Prize, is an independent non-profit medical relief organization working in over 80 countries all over the world. In Turkmenistan, MSF has been working in close co-operation with the Ministry of Health and Medical Industry and National Health Workers in the fight against TB.