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ETHIOPIA: Q/A with WHO Assistant Director-General

[This report does not necessarily reflect the views of the United Nations]

ADDIS ABABA, 27 September (PLUSNEWS) - Jack Chow is the Assistant Director-General of the World Health Organisation (WHO). During a recent visit to Ethiopia he highlighted the combined-global threat from HIV/AIDS and tuberculosis, two of the world’s leading killers claiming 13,000 lives a day, and told PlusNews that billions of productive dollars are being lost from both diseases. Below are excerpts from the interview.

QUESTION: Why the need to combine HIV and TB therapy?

ANSWER: One third of the world’s population is currently infected with TB. There are 38 million people who live with HIV. TB is the leading killer of those with HIV and we have the ability through the provision of US $10 million worth of therapy to treat those living with TB and extend their lives and improve the quality of their lives.

Q: Why has this treatment not been carried out before?

A: We are finding that there has been a severe constraint in resources and technical capabilities to deliver in the field. With the advent of the Global Fund and increased donations from countries like the US, Canada and others, we now have the opportunity to build health systems and to increase the pipeline of drug therapy into communities.

Q: Do diagnostics in these areas need to be strengthened?

A: One cannot treat any disease without affirming its presence in a patient. That’s why for both HIV and TB, we are working to improve detection so that those testing positive can get the therapy they need and those who test negative can be provided with strategies to maintain their negative status.

Q: And what is the WHO doing to improve TB diagnostics?

A: We have established a new TB/HIV coordinator and a working group to knit together a comprehensive response for countries to combine the expertise of HIV and TB.

Q: What targets does the WHO have in place to up scale their treatment of TB?

A: Our baseline goal is detection of 70 percent of those living with TB and 85-percent-cure rate for those who have access to therapy. For HIV, we are working very aggressively to treat three million people by the end of 2005. For TB, we are at 37-percent-detection rate and 72-percent-cure rate. We hope to achieve our targets within the next two to three years. We are heartened by the success on the cure side and we believe those targets can be reached.

Q: What is the economic impact on developing countries from these diseases?

A: We are finding that for each of these diseases, billions of dollars worth of productivity have been lost through increased medical care, loss of work output and social insurance costs. So by investing in prevention and treatment, we re-enforce health as a primary pillar of economic development.

Q: Critics say the US pressures developing countries not to produce generic drugs. Do you agree?

A: Well, we need both research-based pharmaceuticals, as well as generics. We know that HIV is powerful and with each replication, it can produce a one-point mutation in the genetic code, so we need new antiretroviral and anti-TB drugs. We need generics to provide cost-effective care at the community level. And WHO is committed to expanding the pre-qualification project for green lighting safe and effective drugs.

Q: How is the WHO addressing weak health systems in developing countries?

A: WHO believes very strongly in the strengthening of health systems, such as training public health workers and giving attention to primary care by addressing other chronic illnesses. In addition to physicians and nurses, we like to see a robust number of well-trained community health and social workers. HIV and TB are not just medical problems and there are many social factors that must be addressed, such as stigma fear and discrimination.

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