November 24, 2007	Saturday	Ziqa’ad 13, 1428

ISLAMABAD, Nov 23: The Global Fund To Fight Aids, Tuberculosis and Malaria (GFATM) has rejected Pakistan’s $24 million proposal for financing the anti-tuberculosis programme in the seventh round of grants, giving rise to fears that over 100,000 patients undergoing Directly Observed Treatment Short Course (DOTS) can go without medicines from next year.

The decision taken at the 16th board meeting of the GFATM could further aggravate the deadly phenomenon of Multiple-Drug Resistant Tuberculosis because of an obvious increase in patient default.

The GFATM was so far one of the major contributors to Pakistan’s TB control programme.

The decision could not have come at a much worse time with the Global Drug Facility (GDF), another contributor to TB control programme, also ending its assistance to Pakistan for procurement of tuberculosis medicines this year.

The problem of unavailability of TB drugs is expected to manifest fully by mid-2008.

The rejection came because of a technical glitch in Pakistan’s proposal. A chance of appeal to the board was offered, but Pakistan refused to avail it sensing poor chances of its appeal getting through.

Instead, Pakistan decided to approach other international donors for meeting the shortfall created by the GFATM’s shock refusal.

As a stop gap arrangement Pakistan has obtained the GFATM board’s permission to reappropriate funds of the sixth round of grants, which is nearing completion. Additionally, the health ministry is requesting the provincial governments to reappropriate funds from other programmes to keep the anti-TB initiative afloat.

Officials in the health ministry are quite optimistic about the response of international donors.

Over 250,000 TB patients are to get DOTS therapy next year. The government bears the expenditure of half of them, while the remaining get treated through external donations and their treatment is now in jeopardy.

Pakistan is fifth among the list of 22 TB high burden countries with incidence of 177 per 100,000 and death toll due to TB close to 50,000 annually. There could be some two million infected patients in the country.

The GFATM in its “Partners in Impact - Results Report” earlier this year had included Pakistan in the four countries suffering from performance problems.

The report said: “While most countries can make the money work, there is significant variation. There are also important countries with performance problems which require attention, including Nigeria, Uganda, Kenya and Pakistan.”