An old scourge returns

By Wen Chihua (China Daily)
Updated: 2009-08-12 10:03

To harness the growing problem of TB, since 1991 China has implemented a program initiated by WHO called DOTS - "directly observe treatment, short-course", with a bid to achieve a 70 percent case detection rate and 85 percent cure rate by 2005.

The program covered about 3,000 counties throughout the country by 2005. Through DOTS, believed as the most effectual and cost effective strategy for TB control to this day, China detected and cured 6.42 million cases of TB patients between 2001 and 2008. For this mission, the central government allocated 2.16 billion yuan by 2008.

However, "the situation is not yet promising," says Wang Wenjie, director of the division for tuberculosis control under the Health Ministry. Now China has 650,000 cases of HIV/AIDS and TB-HIV co-infection is one of the biggest challenges the country is confronted with in battle against the epidemic, according to Wang.

Firstly, treating people with the co-infections is not easy, Wang says. For one reason, the two medications - anti-retroviral therapy for HIV and the treatments for TB - interfere with each other, and both cause kidney and liver problems.

Compounding the problem is that although anti-retroviral therapy access has greatly expanded in China since 2004, it is still difficult to give HIV tests to TB patients, and to detect TB early among people with HIV.

Over the past two years, Wang says, "we tried to conduct HIV testing among 120,000 TB patients in 130 counties. Of those patients, 20,000 people changed their minds at the last minute. They were afraid testing might lead to criticism of them, owing to social stigmatization and discrimination directed at people with HIV/AIDS."

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