/ 22 March 2002

In Zimbabwe, TB cases spread on back of HIV and poverty

ISABELLE LIGNER, Harare | Friday

ZIMBABWE has six times more cases of tuberculosis than it did 20 years ago, and the spread of the disease shows no signs of slowing as more people suffer from Aids and poverty, the World Health Organisation said.

Friday has been dedicated to the global fight against TB, a curable disease that thrives on immune systems ravaged by HIV and by the weak health care available to the world’s poorest people.

WHO representative Wendy Samunderu said 50 000 cases of TB were diagnosed in Zimbabwe last year, in a population of 12,5-million people.

The incidence of the disease has shot up from 60 per 100 000 people in 1981 to 384 per 100 000 last year.

To mark World Tuberculosis Day, the Who, Zimbabwe’s health ministry and non-government organisations have organised demonstrations to provide information about the disease in the southern town of Bulawayo, in the heart of the region hardest-hit by the disease.

The campaign is waged under the banner: ”Stop-TB, Fight Poverty.”

”Tuberculosis has greatly increased in our country in connection with HIV/Aids cases,” said Milton Chimoro, national director of the fight against TB.

The Who estimates that Zimbabwe will have 110 000 cases of TB next year, mainly because of the spread of Aids, which kills more than 2 000 people a week, with one in four adults infected with HIV.

In Africa, TB is the top cause of death for people with HIV or Aids, whose weakened immune systems make it easier for the disease to take hold.

Sister Margaret, at Harare’s Mashambanzou palliative care unit, said better coordination is needed between programs that fight AIDS and TB.

”Often, the patients have suffered from a lack of cooperation between the specialists of these diseases,” she said.

Chimoro said poverty compounds the disease.

”TB is curable, but this infection remains a major cause of death amongst poor communities because of a lack of information and poor access to care and drugs,” he said.

Zimbabwe, suffering its worst-ever economic crisis, has seen a sharp rise in poverty, leaving 80% of the population below the poverty line.

”Poverty makes it worse,” Samunderu said, adding that hunger also makes people more vulnerable to the disease.

The World Food Program (WFP) estimates that more than 500 000 people are threatened by famine, caused by the upheaval on farms under the government’s violence-wracked land reforms.

TB is an infectious disease caused by a bacteria which attacks the lungs, glands, brain and genitals. Nearly two million people worldwide died of TB last year.

Anti-TB drugs are cheap, but remote parts of the country have no access to the medication.

In Zimbabwe, the most common treatment program costs only 11 dollars per patient, and works in 80% of cases.

But few patients have access to the treatment, because it must be administered daily under medical supervision, which is almost impossible in rural areas.

Specialists have also begun detecting drug-resistant strains of tuberculosis.

The disease costs Zimbabwe an estimated $12-million dollars a year.

The country has a lower incidence than Zambia, which has 425 cases per 100 000 people, but more than South Africa at 216 per 100 000. – Sapa