Asia Faces Trillion-Dollar TB-Fighting Bill

Eleven Asian nations facing the biggest threat from tuberculosis risk being saddled with a whopping trillion-dollar economic burden over the next 10 years if they do not beef up their anti-TB strategy, a landmark study shows.

Led by China and India, the countries are already implementing a prevention and treatment strategy, popularly known as DOTS introduced by the World Health Organization (WHO) in the 1990s.

But the DOTS (the directly observed therapy) strategy was not sufficient to reduce the incidence of the disease, particularly in HIV-infected people and due to drug resistance, and had to be restructured.

A World Bank study released last week for the first time captured the economic benefits of extending the revamped DOTS strategy as proposed in the organization’s Global Plan to Stop TB covering the 2006-2015 period.

The research covered 22 “high-burden” tuberculosis-endemic countries, including China, India, Indonesia, Philippines, Thailand, Afghanistan, Bangladesh, Cambodia, Myanmar, Pakistan and Vietnam.

“These Asian nations have to grapple with a 1.17 trillion dollar economic cost over a 10 year period if TB prevention and control are sustained at current levels of treatment,” Ramanan Laxminarayan, an economist who led the study, said.

“But if they embrace WHO’s global plan they could collectively save about US$10 billion each year or $100 billion during the 10-year period,” he said. “However, the costs of the global plan may be greater than these benefits in some countries.”

TB is the leading infectious killer of adults in Asia. The worst affected nations are China, India and Indonesia.

“This important new study shows us why TB control is a smart investment in lasting development for low-and middle-income countries,” said Joy Phumaphi, the World Bank’s vice-president for human development.

“This economic justification for TB control strengthens the case for governments and donors to sharply reduce TB prevalence and deaths in the name of better health and higher incomes for people living at grave risk of TB illness and death,” Phumaphi said.

The economic impact of TB deaths and the benefits of TB control among the 22 high-burden countries are greatest in China and India, where the combination of growing incomes and a relatively high number of TB deaths translates into a significant economic effect, the study showed.

Laxminarayan pointed out that the 11 Asian nations accounted for one million of the 1.7 million deaths from TB in the 22 countries covered by the study, saying that extending DOTS coverage could slash mortality considerably.

“Implementing the global plan has the potential of averting about 100,000 adult deaths per year,” he said.

“The burden of TB in Asia while not as large as in Africa is a serious threat to public health,” said Laxminarayan, who works with Resources for the Future, a Washington-based nonprofit research group.

WHO and World Bank experts were also involved in the study, commissioned by the Washington-based bank on behalf of the Stop TB Partnership and funded by the Bill and Melinda Gates Foundation, a charity of software tycoon Bill Gates and his wife.

The study entitled “The economic benefit of global investments in tuberculosis” has attracted considerable interest from international health and development agencies, along with research and civil society groups, bank officials said.

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