Utopia? WHO wants a world without tuberculosis

Utopia? WHO wants a world without tuberculosis

03/24/2015

Although tuberculosis (TB) is on the decline across Europe, more than 4,000 people in Germany still suffer from the dangerous infectious disease each year. The World Health Organization (WHO) has announced a plan to eradicate TB on World TB Day. Is that possible?

Germany did not progress in the fight against TBC
Although tuberculosis (also known as TB or TB) is declining in Europe, it is still a problem in Germany as well. According to a report by the news agency dpa, new data shows that Germany has not made progress in the fight against the disease. Thus, the Robert Koch Institute (RKI) reported in the run-up to the World Tuberculosis Day on this Tuesday 4,318 people in Germany in 2013 ill. This is about 100 cases more than in 2012 and almost as many as 2011. The World Tuberculosis Day is reportedly the anniversary of the first description of the bacterium Mycobacterium tuberculosis by the later Nobel laureate Robert Koch.

Eradication of the disease as a target
In Germany, slightly more than five out of every 100,000 inhabitants have contracted the infection in recent years. Although this is little compared to other countries, but since 2009, the rate hardly drops and last even slightly up again. It needs new efforts to achieve the WHO goals. This follows from this year on the strategy: „End TB“. The goal is a world without tuberculosis. It is said that the framework plan for 2050 low TB countries provides for eradication. Deaths are to be reduced worldwide and treatment costs reduced. In many cases, TBC can be successfully treated with antibiotics. The disease, also known as tuberculosis, usually occurs as an infection of the lungs. Symptoms such as persistent cough, chronic fatigue, weight loss, nocturnal sweat fever, and chest pain can be signs of tuberculosis.

Public health service is understaffed
The WHO hopes for a vaccine that could be available by 2025. The BCG vaccine, introduced in Germany in 1930, has not been recommended in this country for a long time, as it is considered to be less effective. The public health service (ÖGD) plays a central role in controlling TB. However, not only in Berlin is understaffed. The tuberculosis center in the capital, where all asylum seekers are routinely tested for illness before moving into a shared accommodation facility, has been working at the limit for months. For example, refugees have to wait a long time for the examination and the school enrollment of children is delayed. They often come from countries with inadequate health care. More than half of the TB patients registered with the RKI in 2013 were born abroad.

Multi-drug resistant forms of tuberculosis
As physicians Karl Schenkel of the German Central Committee for the Control of Tuberculosis (DZK) said, those who are ill must be diagnosed early to prevent further infections. Especially in countries of the former Soviet Union multidrug-resistant forms of tuberculosis are prevalent, caused in particular by discontinued or incorrect therapies. Already with normal TB treatment, patients must take four types of antibiotics for half a year. The infection biologist Stefan Kaufmann, Director of the Department of Immunology at the Max Planck Institute for Infection Biology in Berlin explained that the longer the treatment takes and „the heavier the bullets“, the sooner patients do not take their medication regularly. „This creates further resistance.“

Two new agents approved
In the meantime, doctors from Latvia, Lithuania, Romania, Bulgaria and other particularly affected countries in Germany are being trained in the correct use of two antibiotics launched on the market in 2014. Kaufmann sees the first approval of new TB drugs for years as a success, but sees no reason to breathe. It is said that the funds are mainly for those patients „drinking straw“, who are suffering from multidrug-resistant TB form. This is around 480,000 people worldwide per year, around 100 in 2013 in Germany. With a two-year treatment period, the chances of recovery are 50 percent. Kaufmann fears a kind of sustainability problem: „All the ingredients we use today will be missing to our children. Every new remedy is good, but probably only temporary.“ According to the infection biologist, who is himself researching new vaccines, a good dozen vaccines are currently being investigated in clinical trials. In the most affected regions, the disease can only be eradicated in the long term.

Preventive treatment
However, there may be more important options for regions with very high infection rates, which are also being worked on. Namely, methods that show who actually breaks out of the disease. Then patients could be treated preventively. According to experts, in up to 95 percent of the cases, the immune system succeeds in controlling the pathogen on first contact. Then there is a latent tuberculous infection without symptoms. According to Karl Schenkel from the DZK, GPs in this country rarely encounter the TB condition. That also speaks in favor of strengthening the role of the ÖGD. According to Schenkel, apart from refugees, there are also EU citizens without insurance cover, who would have to be better cared for in terms of TB. Migration and mobility have brought regions of low and high TB ​​rates closer together, the RKI said in a new report. (Ad)