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or money

By Bob Unruh
© 2007 WorldNetDaily.com

The World Health Organization is appealing for billions of dollars in funding to avert the
apocalypse en route if a virtually untreatable form of tuberculosis that already infects 30,000
people a year is left unchecked.

The TB, called XDR-TB for extensively drug resistant, is virtually immune to currently
available antibiotics, turning aside the effects of both front-line and secondary drugs,
officials have said.

It has been in the news of late because of an American airline passenger, Andrew Speaker, an
Atlanta, Ga., lawyer, who was diagnosed, then traveled to Europe for his wedding, and returned,
on commercial airliners, potentially exposing hundreds of people to the frequently fatal
disease.

He now is being treated at a special center in Denver that deals with cases of tuberculosis.

"XDR-TB is a threat to the security and stability of global health. This response plan
identifies costs, milestones and priorities for health services that will continue to have an
impact beyond its two-year time line," said WHO Director-General Dr. Margaret Chan.

The organization is appealing for $2.15 billion in funding to develop a battle plan - and
tools - to fight the drug-resistant TB. It is expected that it would save 134,000 lives over
two years, and many more in the future.

The extensively drug resistant TB has been reported in 37 countries in all parts of the world
since it first was identified in 2006, the agency said.

"There is somewhere between 25,000 and 30,000, we roughly estimate, cases of extensive drug
resistant TB each year," Paul Nunn, coordinator of WHO's Stop TB Department, informed a recent
meeting.

The program, called "Global MDR-TB and XDR-TB Response Plan 2007-2008" sets out measures needed
to prevent, treat and control those threats. MDR-TB is multiple-drug resistant, while XDR-TB is
extensively drug resistant.

WHO officials said the plan also launches "actions" that would reach a 2015 goal of providing
access to drugs and diagnostic tests to all MDR-TB and XDR-TB patients, "saving the lives of up
to 1.2 million patients," officials said.

Included will be investments in programs to treat patients, building capacity in diagnostic
laboratories, expanding infection control and surveillance, and funding research into new
attacks on the disease.

"We have sounded the alarm on the potential for an untreatable XDR-TB epidemic. Today we issue
our response on behalf of all patients and communities whose lives are most at risk. It is an
ambitious plan that must be fully supported if we are to keep a stranglehold on drug-resistant
TB," said Dr. Mario Raviglione, director of the WHO Stop TB Department.

It was in March 2006 when researchers reported their encounter with the extensively resistant
TB strains. Within a few months, a cluster of "virtually untreatable" XDR-TB cases was reported
in South Africa, aggravated by a high prevalence of HIV.

"All but one of the 53 patients died in an average of 25 days after samples were taken for drug
resistance tests," the agency said. Then Speaker's case, "focused attention on the need to
address the TB epidemic as an immediate international priority."

"A highly important element of the plan is a steady supply of quality drugs to treat MDR-TB and
XDR-TB in underserved countries," said Dr. Marcos Espinale, executive secretary of the Stop TB
Partnership. "The Partnership's Global Drug Facility is ensuring supply of these drugs to a
growing number of countries, after our Green Light Committee has verified that applicant
countries meet its technical standards and will use the drugs correctly."

MDR-TB is defined as being resistant to main first-line drugs such as isoniazid and rifampicin.
More than 400,000 such cases are reported each year, and it emerges generally when it is spread
from one person to another, or the drugs used to battle ordinary TB are mismanaged, allowing a
resistance to develop, officials said.

The XDR-TB develops when there is resistance to all of the most effective anti-TB drugs, and
the fluoroquinolone drugs as well as some of the second-line injectable drugs, amikacin,
capromycin and kanamycin.

The problem is with the tendency for such infections to grow exponentially, said Raviglione.

"That is the big threat here. If you have more and more of these cases, you will automatically
magnify the problem by having transmission going on to other individuals ... Once they become
infected they are sort of a time bomb," he said.

"If this is kept unchecked and goes on, then you may also see an apocalyptic scenario where the
present epidemic of TB is replaced by an epidemic of TB which is now fully resistant to
everything," he added.

In such a situation, the toll could be massive. Currently 8.8 million people each year develop
normal TB, a bacterial infection (Mycobacterium tuberculosis) that usually attacks the lungs.
It already kills 1.6 million annually, WHO said.

"The possibility is that you could replace that epidemic with a drug-resistant epidemic, in
other words you could have 8 million cases of drug-resistant TB wandering around. And then you
will be back to the pre-antibiotic era," said Nunn.

"We really now have to focus on problems of infection control. We can't allow drug-resistant
MDR or XDR to get into populations of HIV-infected people," he added.

Ordinary TB can be diagnosed with a microscope, but drug-resistant forms require much more
sophisticated tests - and labs, which are missing in many poor countries. And ordinary TB
usually can be treated over a course of six months or so; the more drug-resistant varieties
could take two years.

"It's basically a death sentence. If people are failing first- and second-line drugs and we
don't have in the pipeline a new drug for immediate use, that's a crisis," said Espinale.