ONE of the world’s most challenging health issues continues to be that of tuberculosis (TB). Despite the stubborn nature of the disease itself and the numerous obstacles and frustrations associated with fighting the illness, Government’s commitment to the Sustainable Development Goal (SDG) of the eradication of TB by the year 2030 remains commendably resolute.

TB is one of the world’s worst killers, particularly of HIV-positive persons. The World Health Organization (WHO) reports that last year, 10 million people, including 1 million children, fell ill and were diagnosed with TB, and 1.6 million deaths occurred from the disease; 230,000 being children. While measurable progress is being made worldwide, the number of new cases is falling by about 2 per cent per year; the rate of decline must immediately accelerate to about 4 or 5 per cent to reach the 2020 milestone of the international End TB Strategy (ETBS).

Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis that most often affects the lungs, although it can infect other organs. The disease is curable and preventable. Most frequently, TB is spread through the air. When someone with lung TB coughs, sneezes or spits, the TB germs are picked up by the air. Another person only has to inhale a few of those germs to become infected. The WHO estimates that about one-quarter of the world’s population has latent TB, which means, they have TB bacteria in their bodies but are not yet sick. And they cannot transmit the disease. Those people with latent TB have a 5 to 15 per cent lifetime risk of getting sick with TB. However, persons with weakened immune systems, such as people living with HIV, malnutrition or diabetes, or people who smoke, have a much higher risk. In fact, 7.9 per cent of TB cases worldwide are attributable to smoking.

When a person gets sick with TB, the symptoms – usually, cough, fever, night sweats, chest pain, weakness, and weight loss – may develop slowly. The victim may ignore the seemingly-mild symptoms, thereby allowing the deadly disease to take hold. The WHO says that without proper treatment, 45 per cent of HIV-negative people with TB, and nearly all HIV-positive people with TB will die.

Treating and curing TB is difficult for numerous reasons: the course of treatment may be long, extending into one or two years. Patients have to stick with the treatment, and, some forms of TB, called multi-drug resistant TB (MDR-TB), are more difficult to treat.

Guyana’s government has identified and tackled those difficulties. According to Dr. William Adu Krow, the local PAHO/WHO representative, new technology has been introduced to shorten the treatment-period from a period of years to about nine months. To ensure that patients take the medicine, government uses the Directly Observed Treatment Short-Course (DOTS) strategy. This means that trained persons deliver and make sure that patients take the medicines. Regarding drug resistance, Minister within the Ministry of Public Health (MoPH) Dr. Karen Cummings reports that “The threat of antimicrobial resistance (AMR) is real and cannot be ignored, so the MoPH will be collaborating with the Ministry of Agriculture to tackle [this issue] through enhanced public awareness, antibiotic conservation, and increased surveillance.”

Work continues through the training of more DOTS workers, a national TB manual has been developed and disseminated to professionals caring for TB patients around the country, annual conferences on TB have been held in collaboration with local and international agencies, laboratories have now been appropriately equipped throughout Guyana’s regions, targeted interventions for children and adolescents have been introduced, counselling and support services are now available, and numerous studies and other feedback mechanisms have been activated.

Government’s commitment to improving the quality and availability of healthcare is reflected in the 2019 budget, with $35.9 billion being allocated to the sector; $2.6 billion more than in 2018. That ongoing commitment is already showing results. Dr. Jeetendra Mohanlall, Programme Director of the National Tuberculosis Programme has disclosed that for the 2016 to 2017 period, the TB Programme recorded a reduction in the number of related mortalities to 8.2 per cent per 100,000.

Because of the slowly-progressing nature of TB, The Ministry of Public Health, as well as international agencies, is now working to accurately quantify the effects of government’s efforts. However, clearly, progress is being made, and there is little doubt that benchmarks and milestones will be met as government continues its systematic work.