Antimicrobial (including antibiotic, antiviral, antifungal
and antiprotozoal) agents are critical tools for fighting diseases in humans,
terrestrial and aquatic animals and plants, but they are becoming ineffective.
Antimicrobial resistance (AMR) has become terrifying as
diseases that were once easy to treat are being rendered virtually incurable.
One of such is Tuberculosis (TB), one of the top 10 causes
of death worldwide, a curable and preventable disease caused by the
bacteria (Mycobacterium Tuberculosis) that most often affects the lungs.
The World Health Organisation (WHO), in its report “No Time
To Wait: Securing the Future From Drug Resistant Infections April 2019’’, notes
that drug-resistant diseases already cause at least 700,000 deaths globally a
year, including 230,000 deaths from multidrug resistant tuberculosis.
The figure could increase to 10 million deaths globally per
year by 2050 under the most alarming scenario if no action is taken, the report
presented to the Secretary-General of the UN, Antonio Guterres says.
Recent discourse alerts that Multidrug Resistant TB (MDR-TB)
remains a public health crisis and a health security threat, hence the urgent
call to action to end TB and MDR-TB because of the huge economic, health,
environmental, mental and social implications.
Also, ending the TB epidemic by 2030 is among the health
targets of the Sustainable Development Goals.
A new report by the Economist Intelligence Unit (EIU)
also emphasises the urgent need for focused global action to address the
growing threat of drug resistant tuberculosis (DR-TB) as it is the leading
contributor to deaths from antimicrobial resistance (AMR).
The EIU is the thought leadership, research and analysis
division of The Economist Group and the world leader in global business
intelligence for executives.
The report:“A Call to Action: It’s Time to End Drug
Resistant Tuberculosis’’, published on Tuesday, May 7, was made possible
with support from Johnson & Johnson.
According to the report, TB has been adjudged as one of the
world’s deadliest infectious disease as nearly one-quarter of the world’s
population, 1.7 billion people, are infected with Mycobacterium tuberculosis,
the bacterium that causes tuberculosis.
In most of them, the infection is in a dormant state; but
every year, 10 million people develop active tuberculosis and approximately 1.6
million people die from the disease.
In the past 200 years alone, TB has killed over one billion
people, this is more deaths than from malaria, influenza, smallpox, HIV/AIDS,
cholera and plague combined.
On Drug-Resistant Tuberculosis (DR-TB), it is a particularly
complicated form of the bacterial infection and is characterised by resistance
to at least one of the most powerful drugs in the first-line treatment regimen.
DR-TB is the leading contributor to deaths from antimicrobial
resistance (AMR); it is an airborne infectious disease that does not respond to
the most commonly used TB medicines.
The EIU report says that in 2017 alone, DR-TB affected
558,000 people in 2017, causing 230,000 deaths; only an estimated one in three
people with DR-TB are diagnosed, and one in four treated.
Among the treated, only 55 per cent are cured.
To make matters worse, TB is airborne, and one untreated
person can infect 10-15 others in a year through close contact.
Beyond its devastating impact on human lives and the global
health security threat it poses, DR-TB also takes huge impact on the economy.
The analysis shows that DR-TB costs billions of dollars from
loss of life and worker absenteeism, and could reduce foreign direct investment
and tourism.
“Estimates and forecasts now show the enormous cost of
inaction; unchecked DR-TB could cost the global economy 17 trillion dollars by
2050.
“These impacts will play out across multiple direct and
indirect channels.’’
According to the report, based on current incidence and
prevalence rates, DR-TB deaths in a single year are estimated to cost the
global economy at least 17.8 billion dollars.
“This represents a loss of future gross domestic product in
purchasing power parity (PPP) terms, due to deaths from DR-TB globally (i.e.,
230,000 in 2017).
“In addition, in a single year, DR-TB causes a loss of at
least 3 billion dollars in PPP terms due to work absences in the approximately
100 countries for which data were available.’’
In Nigeria, the report shows that the country incurred 0.26
billion dollars Future GDP at PPP losses due to early mortality from Drug Resistance
(DR-TB) in 2017.
Speaking with NAN in an earlier interview, Dr Victor
Babawale, a Senior Medical Officer in the National Tuberculosis and Leprosy
Control Programme (NTLCP), Federal Ministry of Health (FMoH), Abuja, had
highlighted the challenges of MDR-TB.
“MDR-TB is resistant to drugs and it is more difficult to
treat; it has a higher mortality and morbidity rate but in all, TB disease has
high mortality.
“At least we have recorded 67 per cent out of a 100,000
population in terms of mortality rate of TB in Nigeria.
“From our data surveillance system, it shows that out of
that estimated 400,000 cases of tuberculosis annually, we are only able to
detect 140,000, which is one fourth of TB that can be detected in Nigeria.
“This means that ¾ (three over four) are out there spreading
the disease and the mode of transmission of TB is easy, it is by air,’’ he
said.
Alarmingly, the EIU report states that the estimates are
conservative.
They do not include the economic impacts of work absences
among the approximately 400,000 people annually with DR-TB who are not
diagnosed and treated, or the nearly 70,000 estimated undocumented deaths from
DR-TB.
Without urgent action and a robust policy response to
reverse these trends, these costs will only grow, yet more people will lose
their lives.
Jaak Peeters, Global Head, Johnson & Johnson Global
Public Health, Janssen-Cilag GmbH says: “The EIU report sounds the alarm
on DR-TB.
“If the disease continues to be left unchecked the damage to
people’s lives and entire economies could be devastating.
“Turning the tide on this disease requires that we act
immediately; by working together in new ways and with a real sense of urgency,
we can end this deadly airborne threat,’’ Peteers said.
Going forward, addressing the trend requires the world to
act immediately as the cost of inaction is high and it will require good value
for money.
The EIU report says there must be investment in diagnosis
and treatment of DR-TB because of the high benefit-to-cost ratio.
It also recommends full funding for Research and
Development; also proper diagnosis and linkage to care are essential.
“Addressing DR-TB must align with other important health,
economic and societal priorities.
“ National leaders, in partnership with other stakeholders,
must be held accountable for progress to end DR-TB.
“Stronger public advocacy is required; it will be critical
to ensure that governments and policymakers remain committed to the fight
against DR-TB and tuberculosis as a whole.
“The voice of the TB community is critical for engaging a
wider group of stakeholders to drive change,’’ the report advises.
Peter Sands, Executive Director, the Global Fund to Fight
AIDS, TB and Malaria, says innovation, collaboration, improved execution and
better use of data are essential if we must achieve the SDG ambition of ending
TB by 2030.
In summary, millions of lives can be saved over the coming
years, and the very real threat of DR-TB can be ended by a combination of
increased commitment, investment and coordination at the local, national and
global levels.
“This disease can be ended, and we all have a role to play,”
the report says.
