KARACHI, June 18: About a third of world's population is infected with mycobacterium tuberculosis (TB) and every year around 8.8 million new TB cases appear, approximately half of which can transmit the disease to others, experts said.

Furthermore, there are more than seven million TB cases in the 22 high burden countries (HBCs), including Pakistan, yet these states are exposed to a condition where large majority of their general medical practitioners are registered to lack adequate diagnostic skills as well as capability to make proper prescription of required drugs.

The situation, therefore, turns imperative for medical schools, particularly in the HBCs, to address the major health problem on a priority basis, regardless of the efficiency of DOTS (Directly Observed Treatment Short Course) implementation by the TB Control Programme Managers.

While doctors play a pivotal role in tuberculosis control not only in the public sector but also in the private sector and the DOTS strategy can also not succeed unless medical students who are the future practitioners are trained to manage TB according to the standardized national guidelines.

Regrettably medical schools across the country have not responded adequately to this public health priority and studies conducted in Africa, Latin America and Pakistan show that the knowledge of medical students, particularly concerning the public health aspects of TB, is very poor.

In order to effectively address the issue, the International Union Against Tuberculosis and Lung Disease (UNION) conducted a workshop on tuberculosis training in local medical only some time back.

Prior to this workshop, another WHO workshop was conducted which determined the educational objectives for tuberculosis of future practitioners, possible educational strategies and highlighted the importance of the assessment of performance not only for theoretical knowledge but also for clinical and practical skills.

Subsequently a tool to support this change, entitled "Tuberculosis - A Manual for Medical Students", was published by WHO/UNION in 2003 following a French version.

Moreover, to advocate for a strategy of change in the medical students curriculum in Pakistan, preliminary summary was conducted in Karachi, including students of various medical schools of Pakistan.

The study, which had alarming results indicating extremely poor knowledge concerning the disease and its treatment, confirmed the need of new actions for improvement of tuberculosis in medical students of Pakistan.

The workshop, organized by UNION in the city, was attended by 36 participants, including senior TB Managers, chest physicians and academicians from Sudan, Mongolia, Indonesia, Philippines, Mozambique, Thailand, Vietnam and Malawi in addition to a sizable participation from Pakistan.

The main purpose of the workshop was to promote a strategy to improve teaching in medical schools in order to enable future medical practitioners to contribute effectively to the management of TB programme. -APP