ISLAMABAD: While World Tuberculosis (TB) Day will be observed today with the theme ‘Yes We Can End TB’, the cases of drug-resistant TB in Pakistan are going to become a major challenge as “75pc of them are not identified”.

With Pakistan ranking fifth among high-burden countries globally, the country witnesses approximately 608,000 new TB cases and 15,000 drug-resistant TB cases annually.

National Coordinator Common Management Unit (CMU) Dr Razia Fatima, in a message regarding the day, said that in 2023, Pakistan’s efforts to combat TB reached unprecedented levels, with a comprehensive array of initiatives and strategies implemented nationwide. It is worth mentioning that the CMU is an ancillary department of the health ministry and deals with TB, Aids, and malaria.

“TB services were provided free of cost at over 1,500 public and private facilities, including more than 15,000 general practitioners. Notably, the country transitioned to WHO-recommended short, all-oral patient-friendly TB treatment regimens for drug-resistant TB (DRTB), significantly improving treatment outcomes and patient experience,” she said.

Pakistan ranks fifth in world, reports 608,000 cases every year

“With support from the Global Fund and concerted efforts…Pakistan rolled out the case-based District Health Information Software 2 (DHIS2) system across all provinces and regions, enhancing disease surveillance and data digitalisation,” she said.

She said that the private sector also played a pivotal role in the fight against TB, engaging over 8,000 general practitioners, more than 300 large private hospitals, and over 400 private laboratories across the country.

“Active case-finding initiatives, including mobile vans, have facilitated the detection and notification of over 150,000 TB cases, demonstrating the collaborative efforts to combat the disease. Furthermore, proactive measures such as the employment of Lady Health Workers by provincial governments and the training of healthcare workers through online courses have significantly enhanced TB screening, diagnosis, and treatment, particularly in Punjab, Sindh, Balochistan and Khyber Pakhtunkhwa regions,” Dr Razia Fatima said.

“Despite these commendable achievements, challenges persist, including barriers to TB preventive therapy delivery and the need for continued investment in healthcare infrastructure and human resources. However, the successes outlined above exemplify the feasibility of ending TB through concerted efforts and collective action,” she said.

“On this World TB Day, we call upon all stakeholders – policymakers, healthcare providers, researchers, and communities – to renew their commitment to ending TB. By raising awareness, advocating for equitable access to healthcare, and supporting TB programs, together, we can achieve a TB-free world,” she said.

Federal Secretary of the Ministry of National Health Services Iftikhar Ali Shallwani reaffirmed the Government of Pakistan’s commitment to combating TB by ensuring free diagnostic and treatment facilities across public and private health institutions.

“Furthermore, the government is committed to providing TB preventive treatment to more than 1.2 million individuals, demonstrating its steadfast commitment to saving lives and protecting communities,” Mr Shallwani said.

75pc TB cases

However, international non-government organisation Doctors Without Borders (MSF) has claimed that over 75 per cent of drug resistant tuberculosis cases were not identified in Pakistan.

It encouraged medical service providers and practitioners to enhance DRTB diagnosis by increasing the use of GeneXpert diagnostic testing among suspect tuberculosis cases.

It is worth mentioning that it takes around six months to treat a TB patient but if the patient discontinues treatment, the TB bacteria develops resistance against the medicines.

It is worth mentioning that MSF is a worldwide TB expert and one of the biggest non-government providers of TB health services leading global efforts to reduce the price of accurate, and timely testing with GeneXpert. Since 2021, MSF has been running the only DRTB treatment site in Gujranwala in collaboration with the Provincial Tuberculosis Control Program (PTCP).

“Many of the patients we see at the PMDT clinic have been misdiagnosed and have a history of unsuccessful treatment regimens, characterised by a cycle of temporary improvement followed by relapse,” Dr. Muhammad Shoaib, MSF medical coordinator said.

“With the correct treatment these patients have a good chance of recovering, but they need to be identified as DRTB patients first,” he said.

Published in Dawn, March 24th, 2024