KARACHI: Experts at a seminar held on Monday expressed concern over the growing number of tuberculosis (TB) cases in the country, stating that a major barrier in tackling the challenge was a lack of public awareness about the disease and the places to seek care from.

The event was organised by the Stop TB Partnership Pakistan in collaboration with the Centres for Disease Control (CDC), Sindh, and Pfizer Pakistan.

Leading stakeholders, including members of non-profit organisations (NPO), TB survivors and members of academia attended the event.

Dr Sharaf Ali Shah of the Stop TB Pakistan updated the audience on the current situation of TB in Pakistan.

He informed the audience that, according to estimates, 611,000 people fell ill due to TB in Pakistan in 2021, whereas 48,000 HIV-negative and 2,100 HIV-positive people died due to TB in the country. Only 55 per cent of the cases, however, were notified, he added.

Highlighting the reasons for low TB case notification, he said these factors included poor understanding of TB and its symptoms (lack of awareness), poor knowledge about where to seek care, misconceptions about anti-TB drugs, a lack of availability of drugs at public sector health facilities, the cost of transportation that poor patients had to bear, and the loss of their daily wages.

Throwing light on HIV-TB co-infection, Dr Afshan Isani, provincial TB adviser at CDC-Sindh, said that tuberculosis and HIV were both infections that facilitated each other.

“HIV-infected persons are at increased risk of acquiring TB, and the management of TB HIV co-infected cases is more challenging. The number of new HIV cases is increasing every year. In 2022, about 30,000 new HIV cases were registered in the country,” she said.

Dr Salim Kazmi, senior technical adviser at the CDC, said globally, a lot was being done to implement the strategy that aimed to end TB. Some recent developments included reducing the duration of treatment in certain cases to four months and for drug-resistant TB to six months.

Sharing his thoughts, Dr Karam Shah of Stop TB Pakistan said that there was an urgent need to engage policymakers at the district, provincial, and federal levels to promote political commitment so that TB was declared a health priority and adequate funds were allocated.

He highlighted that according to the latest WHO Global Tuberculosis Report 2022, the total available funding for TB in Pakistan in 2021 was $47 million, out of which domestic funding was only eight per cent of total funding and 92pc of total funding came from international donors (mainly through the Global Fund to fight against AIDS, tuberculosis, and malaria).

“Besides low allocation of domestic funds, timely release of funds without cuts and proper utilisation of allocated funds are common issues. Total dependence on international funding raises serious concerns about the sustainability of TB control services,” he said.

The event included an interactive discussion comprising four panellists — Prof Iftekhar Ahmed and Dr Saifullah from Dow University of Health Sciences (DUHS); Dr Rumina and Prof Nisar Rao from Aga Khan University (AKU); and Dr Nausheen Ahmed from the Jinnah Postgraduate Medical College (JPMC).

The experts stressed the need to update the medical curriculum regarding TB.

Prof D.S Akram, a senior paediatrician, commented that the diagnosis of TB in children was more complex, requiring better testing tools. Unfortunately, about 12pc of our TB patients were children, he said.

Profs Shahna Urooj and Rafique Khanani stressed the need for the widespread availability of rapid diagnostic tools.

Country manager of Pfizer Pakistan S.M. Wajeeh said the growing number of tuberculosis cases in Pakistan signified the urgency for interventions at multiple levels.

“The campaign Humara Azam TB Khatam aims to educate the masses about TB symptoms and its prevention while clearing the misconceptions associated with it,” he said.

Published in Dawn, April 11th, 2023