among high-burden TB countries, preceded only by India, China and Nigeria.
“An estimated 0.5 million people in Pakistan develop TB every year. Of these, 3.7% will develop Multi-Drug Resistant (MDR) TB, with 18.1% being retreatment cases,” Dr. Ejaz informed. Pakistan’s target is to reduce by 50%, the prevalence of TB in the general population by 2025 in comparison to 2012, “and this requires a decline in TB incidence at the rate of 10% per year,” he stated. At present, China is the only country where TB incidence is declining at the rate of 6%, largely due to a combination of positive factors including rapid development and improved health services, among others.
Dr. Ejaz emphasised that alongside the provision of free drugs and diagnostic facilities, Pakistan will have to involve other stakeholders such as the ministries of education, housing, and agriculture for a befitting response to the TB epidemic. He was happy to inform that new technologies such as gene Xpert-a rapid diagnostic test-has been introduced, and that 30,000 patients have had the test. “This technology will soon be introduced in all district hospitals across Pakistan. Sixty machines have already been procured,” Dr. Ejaz stated. He also shared that 1,396 microscopy centres in the public and private sectors are currently functional, and that a network of 30 TB Culture and Drug Sensitivity Laboratories is being established. “These laboratories will be functioning in the next couple of months,” he added.
Dr. Ejaz emphasised that since free diagnosis and treatment of TB is available in over 5,000 health facilities across Pakistan, no patient seeking services should remain deprived in any way. He also shared details about the 30 designated sites for treatment of MDR TB. “Pakistan has a treatment success rate of 75% for MDR TB,” he said. Outlining the strategic vision of NTP, he said, zero TB deaths by 2025 is our goal. He said, while TB mortality has declined by 50%, there is a need to accelerate the decline in prevalence.
NTP has successfully negotiated US $133 million support from the Global Fund for the next three years (2015-1017). This may be great news, but it is time Pakistan shed its reliance on donor funding and assumed ownership of all health programmes, including TB.
The participants of the seminar were also apprised of the way forward. In this context, the aims include provision of free TB diagnosis and treatment to 1.5 million TB cases; increasing TB case notification from 61% in (2013-14) to 80% (2017-18) of total estimated TB cases; diagnosis and treatment of 15,000 MDR-TB cases; increasing MDR-TB case notification from 18% (2013-14) to 32% (2017-18) of estimated TB cases; screening of more than 110,000 TB cases for HIV infection; increasing TB/HIV screening from 3% (2013-14) to 10% (2017-18)’ and establishment of 12 hi-tech bio-safety level- II and III labs as per national requirement, increasing from 10 (2013-14) to 22 (2014-15). Moreover, the TB case e-surveillance system will be scaled up from 114 districts (2013-14) to all 142 districts (2014-15) to provide 100% coverage for monitoring of all TB patients.
Earlier on, Dr. Kutbuddin Kakar from WHO read out the message of the WHO regional direction for Eastern Mediterranean Region Dr. Ala Alwan. Powerful messages highlighting the need for uninterrupted treatment were disseminated by 7 year-old Aleeza and Majid, both of them TB patients now enjoying the fruits of complete recovery. Unlike events of the past, this year’s seminar was short and crisp, and ended on a high note.