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Local TB programme doomed if challenges not addressed

Mar 30, 2009 News

– drugs for multiple-resistant strain in short supply

The National Tuberculosis (TB) Strategic Plan of Guyana 2008-2012 would be doomed to failure if serious and formidable challenges facing the National TB Programme are not addressed.

This notion has been highlighted in the Health Ministry’s Strategic Plan for TB, which states that these challenges have triggered the elaboration of specific strategies in order to improve the fight against TB in Guyana.

Principal among these challenges is the fact that there is a strong correlation between TB and the Human Immuno-deficiency Virus (HIV) within the population.

Detailed in the strategic plan is the revelation that both diseases are following the same epidemiology pattern and the most current evidence confirms that the majority of cases of both diseases are detected among persons between the age of 20 and 50.

It has further been established that TB and HIV generally afflict the most economically active segment of the population.

However, there are still some gaps in the implementation of collaborative activities between TB and HIV programmes.

The strategic plan also recognises that the variability of incidence from community to community should also be considered as a major challenge, outlining that specific strategies should be envisaged in order to reach some communities and provide DOTS services to all vulnerable groups of the population.

The plan emphasises that “there is a strong concentration of TB services in some specific regions of the health system (and that) the process of decentralisation remains partial, since the Primary Health Care facilities are not fully involved yet.”

As such, it is noted that there has been a steady increase of the number of cases over the years while the resources remain insufficient even as the case detection rate is low and treatment success is still yet to improve.

Stressing the need for urgent improvement in the quality of DOTS, the strategic plan states that some vulnerable and high-risk groups have been identified within the general population including: indigents, socially disadvantaged, drug addicts, homeless, and co-infected among others.

As such it is the anticipation of the Health Ministry that the plan will envision strategies geared at enhancing a more consistent and effective delivery of DOTS services to the vulnerable groups.

Another challenge lies in the fact that there is still need to keep a proper and updated national register as recommended by the World Health Organisation, which would include additional information on TB-HIV cases. Serious and important steps have since been taken in this regard, the plan notes.

It also outlines that the current management of Multi-Resistant Drug-TB cases do not follow all international guidelines and recommendations, thus the prevalence of the problem is not assessed. Also, there is no effective management and there is insufficient supply of drugs for such cases.

The plan states however, that the configuration and weaknesses of the health system have to be highlighted as a particular issue hampering the implementation and the expansion of DOTS in some specific Regions of the country if efforts are to be engaged to effectively address the scourge of TB.

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