Nine year old Sabbir was ill. For several weeks he complained of chest pain and had a bad cough, sometimes coughing blood. His parents took him to a pharmacy where he was misdiagnosed and given ineffective medication. When his symptoms did not go away, Sabbir went to a doctor who fortunately recognised the symptoms of tuberculosis or TB. The doctor referred Sabbir to a nearby hospital but after three months of treatment his health deteriorated, his weight fell to 42 pounds, and he still tested positive for TB. Sabbir was referred to the National Institute of Diseases of the Chest and Hospital (NIDCH) in Dhaka, supported by the United States Agency for International Development (USAID's) Challenge TB programme, who discovered Sabbir had drug-resistant TB. NIDCH staff began a specialised medical treatment regimen and after 19 months of hospital, home treatment and drug therapy, Sabbir gained weight, finally tested negative for TB, and is now a healthy young man back at school.
Tuberculosis is the world's most lethal infectious killer. It is an ancient malady caused by a bacillus spread when people expel bacteria into the air, usually by coughing. When people with TB cough sneeze or spit, they propel TB germs into the air. A person needs to inhale only a few of these germs to become infected. Those with active TB in the lungs may experience a persistent cough, fatigue, fever, weight loss and night sweats.
If not treated, TB can lead to death. TB claims more lives than HIV/AIDS and malaria combined. But it is a preventable, treatable and curable disease.
Training paediatricians to better identify and treat TB is an important part of US/Bangladesh programmes to prevent and cure TB. The community-based multi drug-resistant TB (MDR-TB) treatment is one of the many innovations the US Government, through USAID, supports in partnership with the Government of Bangladesh. As a result of this partnership, Bangladesh accelerated TB case detection and treatment. Bangladesh also piloted the shorter MDR-TB regimen now recommended by the World Health Organization (WHO) and commonly known as the “Bangladesh Regimen”. In 2018, the Bangladeshi government procured first-line TB drugs with its own funding, demonstrating its strong commitment to the fight against the disease.
Despite these promising efforts, Bangladesh accounts for 2.3 percent of the total undetected TB cases worldwide, and almost 70 percent of MDR-TB cases in Bangladesh go undetected.
On September 26, 2018, international leaders met at the United Nations to discuss, for the very first time, the global response to end this epidemic. These leaders made a commitment to end TB by 2030. Worldwide, the US government has been actively involved in the fight against TB through its investments in the Global Fund, WHO, Centers for Disease Control and Prevention, and USAID. Recently, USAID Administrator Mark Green announced a new TB business model, the “Global Accelerator to End Tuberculosis,” which will catalyse investments across multiple countries and sectors, public and private, to end the epidemic.
March 24 is World Tuberculosis Day, an annual event to recognise the day in 1882 when Dr Robert Koch discovered the organism that causes TB. It is a day to recognise achievements in TB prevention and control. And with renewed and focused global commitment, we can defeat TB. Together we can ensure a brighter, healthier future for the children of Bangladesh, like Sabbir, and all children everywhere.
Earl R Miller is US Ambassador to Bangladesh.