Fund scarcity gnawing away at TB programme

Fighting tuberculosis remains an uphill task as the country faces budget shortage while some 1.5 lakh patients of the air-borne disease remain undetected annually, said experts and officials.

For the three-year TB programme since June 2015, Bangladesh had prepared a budget of $153 million, but only some $77 million was mobilised, according to Dr MA Hamid Salim, advisor to Global Fund, and National Tuberculosis Control Programme (NTP). 

The major fund, $66.6 million, came from the Global Fund, $8 million from USAID, $4.9 million from the World Bank as loan and $0.6 million from the government.

During the 2011-15 TB programme, 43 NGOs provided the TB patients with support and care, but now only 28 NGOs are working, said officials at Brac, a principal recipient of the Global Fund money.

"Due to fund crisis, the NGOs had to lay off some 750 staff in the last two years," Dr Shayla Islam, programme head of Brac's TB Control Programme, told The Daily Star on the eve of World TB Day today.

The disease causes harm to lungs, and can be fatal if not treated properly.

Salim said 70 percent of the TB patients detected were aged between 24 and 45 years, adding, "Morbidity or mortality of adults causes families and the national economy a huge loss."

Given worrying trends in tuberculosis worldwide, the United Nations has set a target to reduce TB deaths by 95 percent and cut new cases by 90 percent between 2015 and 2035, and to ensure that no family is burdened with catastrophic medical expenses due to TB.

"If such fund shortage continues, meeting the UN target will be impossible," said the official.

Those who have so far been detected with TB are provided drugs and support through NGOs free of charge under the supervision of National TB Control Programme (NTP).

A normal TB patient needs full six months of medication, while multidrug resistance tuberculosis (MDR-TB) patients need a 24-month medication.

If the detection and treatment is not prompt and proper, higher number of people will be infected by TB and MDR-TB, increasing the number of deaths.

Shayla said the scarcity of fund forced the NGOs working with Brac TB Control Programme to hire volunteers from the community level with low-pays.

Some 1,000 are detected with MDR-TB each year, but 750 patients receive drugs from the Global Fund, she added.

As per the Global Fund's criteria, as Bangladesh is now a low middle income country, it will have to contribute 20 percent of the total fund for the 2017-19 TB programme.

But Bangladesh now contributes less than 1 percent to the total fund, said Salim and suggested significant increase of fund for TB programme.

Dr Mojibur Rahman, NTP consultant, said the fund shortage would utterly affect quality of care and support to the patients.

"We are trying our best to utilise the available fund effectively," he added.