Saturday, 27 December 2008

Cambodia Is Not on the List of 27 Countries Receiving Drugs Against the Drug Resistant Most Serious Tuberculosis of the World - Friday, 26.12.2008

Posted on 26 December 2008

The Mirror, Vol. 12, No. 592

“Phnom Penh: The director of th the National Center for Tuberculosis and Leprosy Control said that Cambodia is excluded from a list of 27 countries of the world with cases of drug resistance related to the most serious tuberculosis, but there are 30 people dying quietly per day in this country.

“The director of the National Center for Tuberculosis and Leprosy Control, and an advisor of the Ministry of Health, Dr. Mao Tan Ieng, telling state and private service providers during a workshop on Thursday morning that, according a new report of the World Health Organization, 27 countries of the world with high numbers of patients with drug-resistant tuberculosis, Cambodia is not among those countries.

“He added, ‘Tuberculosis drug resistance is most devastating; it kills human quietly.’

“He went on to say that in Cambodia, there are between 1.2% and 1.3% of the patients that have drug-resistant tuberculosis, and around 5 to 6 people get infected by tuberculosis per day. At present, 50 to 60 patients with drug-resistant tuberculosis are receiving treatment, and there is still medicine left for curing 100 patients with drug-resistant tuberculosis. He said also that per year, Cambodia has between 400 and 500 patients with drug-resistant tuberculosis.

“He continued to say that drugs to treat a [normal] tuberculosis patient costs US$20 to US$30, while drugs for a drug resistant patient are US$5,000, when the drug is bought from specific organizations. If the national program and the government want to buy it from this chanel, they have to get the permission from the Green Light Committee in Geneva/Switzerland. If one buys from the outside, around US$30,000 are needed to be spent to buy drugs for a patient with drug-resistant tuberculosis.

Note:

As the article does not mention why Cambodia is not on the list of the Green Light Committee - whether it applied and was rejected, or whatever may be the reasons - we quote here from a document of this organization.
One point seems to be crucial: To receive Green Light Committee support, it is necessary to have a strict control of the procedures to apply the drugs - because otherwise the sickness will become more severe.

“SUMMARY

“Controlling multi-drug resistant tuberculosis (MDR-TB) is one of the six components of the WHO Stop TB strategy

“Although prevention must be the highest priority for TB control programs, many countries have patients with drug-resistant TB who must be treated too. Such countries should take specific measures to gradually incorporate appropriate strategies for treatment of this form of tuberculosis into their tuberculosis into their Misuse of second-line anti-TB drugs results in further resistance to these same second-line drugs, creating incurable forms of tuberculosis
“It is imperative that second-line anti-TB drugs are used wisely.

“The WHO Guidelines For The Programmatic Management Of Drug Resistant Tuberculosis (hereinafter referred to as the Guidelines) provide recommendations for appropriate management of drug-resistant TB so as not to generate further drug resistance. To help programs develop and implement strategies for the management of drug-resistant TB, the Green-Light-Committee for Access to Second-line Anti-tuberculosis Drugs (Green Light Committee) was created by the WHO and its partners in January 2000.

“The Green Light Committee consists of six to seven experts in programmatic, scientific, clinical, and microbiological aspects of TB that serve the WHO in an advisory capacity. The Committee is responsible for reviewing applications,evaluating proposed projects,assisting applicants,monitoring approved projects, and contributing to the evidence base for the programmatic management of drug-resistant TB. Each individual and his/her alternate represent a leading public health institution active in TB control internationally. Each institution is allowed one vote, and the Green Light Committee freely consults outside experts as needed. All members are required to adhere to rules of conflict of interest and confidentiality and, thus, are recused for voting onapplications from projects with which they have or had a direct relation.”


“Treatment takes from 18 months to 2 years, while treating normal tuberculosis takes only 6 months.

“According to the National Tuberculosis Control Program, since the start of cooperation between state and private services from May 2005 up to the present, the program has been expanded to 11 provinces and cities covering 36 operational districts among the 77 districts of the 24 provinces and cities.

“Aiming at effient cooperation between the state and the private services to encourage research about and treatment for tuberculosis patients, Dr. Mao Tan Ieng said that in early December, Ms. Monica from the Green Light Committee in Geneva assessed the cooperation and found good results and some inactive program problems that need to be solved.

“An official of the Japan International Cooperation Agency (JICA) associated with the National Tuberculosis Control Program, Dr. Nishiyama, said that JICA supports the cooperation between state and private services that are cooperating to send suspected tuberculosis affected people to be checked and treated with public services of the state.

“He added, ‘Some patients go to discuss with private services, which have a very crucial role to find suspected people and send them to receive state services, so that all Cambodian citizens have good health.

“A Secretary of State of the Ministry of Health, a pharmacist, Mr. Yim Yan, said that tuberculosis infection is very high hazard. Therefore, the Ministry of Health created a policy to link state and private services. He continued to say that we see progress which demands more efforts, and problems faced that we will solve in this workshop.”

Rasmei Kampuchea, Vol.16, #4778, 26.12.2008
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Friday, 26 December 2008

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