Eliminating the Tuberculosis Scourge in Ghana?what Remains to Be Done

By G.D. Zaney

Tuberculosis (TB) is an infectious disease caused by a small germ (micro-organism) known as Mycobacterium Tuberculosis.

Coughing for two or more weeks, fever and chills, chest pains, sweating at night trouble breathing, losing weight and feeling tired most of the time are symptoms of TB.

The threat to TB infection and poor lung health and breathing is aggravated by exposure to risk factors such as indoor and outdoor air pollution, asthma, smoking and pneumonia.

Persons infected with both TB and Human Immuno-deficiency Virus (HIV), without treatment, stand the risk of death. In other words, TB?even with HIV infection?is curable, with early medical attention.

Globally considered the world's deadliest killer disease, persons with TB infection and HIV have a very high risk of developing the TB disease which usually affects the lungs and causes coughing.

According to World Health Organization (WHO) Fact Sheet Number 104, which was reviewed in March 2014 and assessed in April 2014, 8.6 million persons across the globe were ill with TB in 2012, 1.3 million persons of whom, mostly from low and middle-income countries, died from the disease.

TB has become a key challenge to development in the Africa Region, including Ghana, causing extensive human suffering, with serious setbacks for the achievement of the United Nations (UN) Sustainable Development Goals (SDGs).

Although WHO Report 2018 shows that the disease burden caused by TB is reducing worldwide in all WHO regions and in many other countries, the decline is said to be not fast enough to reach the 2020 milestone of the End TB Strategy.

Drug-resistant TB has also been identified as an increasing challenge, with the latest global (2016) TB drug resistance surveillance showing that 4.1 percent of new and 19 percent of previously-treated TB cases in the world are estimated to have rifampicin or multidrug-resistant tuberculosis (MDR/RR-TB).

In Ghana, the recent Drug Resistance prevalence TB survey indicated MDR prevalence of 1.5 percent among new cases and 7 percent among previously-treated cases. This means that all people with TB must be identified and put on the appropriate treatment.

At the United Nations High Level Meeting (UNHLM)on TB in New York in September 2018, it was agreed among all stakeholders that TB was a global epidemic that required a global response.

The most recent Report of the Lancet Commission on Tuberculosis also provides a framework for delivering and meeting the political commitments made by Heads of State and governments.

To that effect, national governments have been urged to increase investments in Tuberculosis (TB) care and prevention as current investments fall far short of the levels required to end the epidemic by 2030?the end date of the Sustainable Development Goals (SDGs).

National governments are also to intensify efforts to identify and remove the challenges that are slowing down progress to ending the TB scourge, as well as adopt and roll out the most cost-effective policy options and interventions.

In addition, they are required to fund core TB control services from domestic resources and, in line with universal health coverage, ensure that quality-assured preventive, diagnostic, treatment and care services are available for all.

To end TB by 2030, universal access to the WHO-recommended rapid molecular tests should be guaranteed as first-line tests for diagnosis for all presumptive TB cases.

The new WHO-recommended drugs and drug combinations for treating drug-resistant TB should also be adopted. Preventive therapy, it is important to note, has also been identified as an effective intervention to reduce TB infection.

This, therefore, calls for the strengthening of Civil Society Organizations (CSOs) and community systems to provide diagnostic support and care where patients live and work, facilitate access to needed services and to assist governments in scaling up services.

The year 2019 is important to GHS as the lead agency of the Ministry of Health to deliver on the UNHLM TB targets while in 2020, GHS will be expected by the international community to show progress and actions towards the political declarations and commitments agreed upon at the UNHLM of Heads of State in New York.

There is no doubt that GHS is up to the task of halting and reversing the TB epidemic? its National TB Programme having developed a major intervention plan?TB Prevention Therapy (TPT)? which requires US$ 13 million annually to meet the funding gap required for the implementation of the plan.

What remains to be done is the mobilization of funds to facilitate finding, treatment and cure for all missed TB cases in order to reach the ultimate goal of ending TB in Ghana.

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