Tuberculosis in Malawi
Malawi has declared tuberculosis a national emergency. Currently over 27,500 people are being diagnosed with the disease every year, but this figure is estimated to be only 50% of all cases in the country. The USAID estimates the total number of new cases each year to be 52,000. The Malawi Ministry of Health has called for urgent and extraordinary actions to halt the spread and fatalities of TB in the country.
In March 2007 the visiting WHO Regional Director for Africa, Dr. Luís Gomes Sambo appealed for national and international solidarity to fight TB in Africa. Dr. Sambo made the declaration of emergency while on a four-day mission to the continent with the UN Special Envoy to Stop TB, the former President of Portugal Mr. Jorge Sampaio. At the meeting the Malawi Ministry of Health announced a new five-year plan to address the emergency through increased access to TB diagnostic and treatment services, TB and HIV services and community involvement.
HIV/AIDS Gets The Most Press Coverage
In spite of the prevalence of the reporting by the world’s press concerning the HIV/AIDS pandemic in Africa’s sub-Sahara there remains a critical crisis with tuberculosis that receives far less attention. The seriousness of the problem can be seen in the following USAID website report:
“The Malawi National TB Control Program (NTP) has been implementing Directly Observed Therapy, Short-Course (DOTS) for two decades, achieving nationwide coverage. The NTP also provides for home-based care using community “guardians” to observe and follow up with TB patients. Despite these advances, the high HIV/AIDS prevalence has had an impact on the success of the TB program. Case detection has remained between 36 and 40 percent during the past five years, well below the 70 percent international standard. Treatment success has remained steady at about 73 percent over the past five years, which is below the 85 percent target.”
The report draws a strong parallel between HIV and T.B.
“In 2004, Malawi had an HIV/AIDS prevalence rate of 14 percent, and more than 1.7 million adults and children in the country were living with HIV/AIDS. An independent, countrywide survey indicated that 72 percent of all TB patients were HIV-positive, a much higher percentage than previous estimates. High rates of HIV infection led to increasing numbers of patients with difficult-to-diagnose smear-negative pulmonary TB, an increasing case fatality rate in patients with all types of TB, and an increasing rate of recurrent disease.”
According to the World Health Organization the total incidence rate of TB in all forms is 8,811,100 with South-East Asia leading the way at nearly 3,000,000. Africa is second at over 2,500,000 cases.