Sep 12, 2006 9:35 am US/Pacific
Experts Urge Fight Against TB In Africa
LONDON (AP) ―
Public health experts accused the World Bank Tuesday of neglecting Africa's fight against tuberculosis, saying the institution should spend more fighting a disease whose resurgence in recent years has been linked to AIDS.
"The World Bank is spending virtually nothing on Africa's TB emergency," said Joanne Carter, of Results International, a US-based anti-poverty advocacy organization.
A report released Tuesday by Results International charged that the bank's support of health projects in Africa unfairly favor HIV/AIDS and malaria, leaving TB with few resources.
Less than one percent of the World Bank's health investment in Africa, or US$3.5 million, went directly to TB control efforts in 2005, despite the fact that TB is increasing at a worrying rate of 5 percent each year. In contrast, the World Bank committed US$167 million to malaria projects in five countries this year, and has provided more than US$1 billion to 29 African countries for HIV/AIDS projects since 2000.
"We urge the World Bank to re-evaluate its priorities," said Carter. Africa is the only continent where TB rates are increasing.
The World Bank, however, says that because HIV/AIDS and TB often go hand-in-hand in Africa, funds provided for HIV/AIDS are also an effective way of reducing the overall TB incidence in Africa. TB is the biggest killer of people co-infected with HIV/AIDS. More than 55 percent of the World Bank's HIV/AIDS financing has direct links with TB, the bank said in response to the Results report.
The World Bank also welcomed the report's call for increased funds in Africa.
In response to criticism that African countries have been treated differently from other TB-endemic countries, such as China, India and Russia, the World Bank said they are moving away from disease-specific projects, toward a more comprehensive national approach that aims to reinforce countries' health infrastructures.
A global plan to halve TB incidence by 2015 was launched earlier this year in Davos by the Stop TB Partnership, a coalition of more than 400 organizations worldwide, identified a $31 billion funding gap, of which approximately $10 billion is needed for Africa alone.
"The situation in Africa is critical," said Dr. Marcos Espinal, executive secretary of the Stop TB Partnership, which was not involved in the Results report. "There are parts of Africa where people have to walk kilometers and kilometers to get treated," said Espinal, adding that health care systems in Africa are not equipped to handle the increasing burden of TB patients.
The problem of drug resistant TB is also emerging in Africa, with the recent identification of an extremely resistant strain in South Africa. The strain was virtually untreatable, killing 52 of 53 people infected in the last year. Experts say that due to poor surveillance, it is unknown how many people may actually be infected with this deadly strain.
More than 65 percent of the total cost of TB control programs in Africa are currently funded by the countries themselves.
"The countries are doing their best, but we need to help them more," said Espinal.
Funds for TB control are also provided by donor countries, other international agencies like the Global Fund to fight AIDS, TB and malaria, and the Bill & Melinda Gates Foundation.
"The World Bank is one of the leading agencies on development issues and an important partner in TB control," said Espinal. "But I hope they look at this study critically and see what can be done in the future."
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