More funding, training needed to stem TB scourge

Feb 14, 2011 News

– Dr Moti Lall

The need for more funding, and the training of health professionals have been cited as two crucial factors to aid the fight against Tuberculosis, according to reputable Pulmonologist, Dr Moti Lall. The renowned physician has for many years been directing his services to the fight against this disease which he insist remains a serious threat to the health sector.
He explained that with the occurrence of the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) the scourge of the disease has intensified considerably. “We have found that TB is a so-called by product of AIDS and what we have found also is that when most AIDS victims die the cause of death is usually TB.” It is for this very reason, Dr Moti said, that there is an urgent need for more attention and an increase in the budgetary allocation to help combat the disease. He asserted that the disease is on the increase.
The Pulmonologist explained too that although a lot of approaches to combat the disease have been engaged by the health sector such as the Direct Observation Therapy Strategy (DOTS) programme there are still some challenges such as the failure of some patients to take their medication. “When these patients do not use their drugs, which is provided at no cost to them, they develop a multiple drug resistance and this is the creeping monster that we have to be watching for very carefully. When these people refuse to take the drug or if they don’t get it for some reason the disease spreads and we have a major problem. It is a problem in Europe it is a problem in far East Asia and it is raising its ugly head in the Caribbean too.” This state of affairs, according to Dr Lall, could be seen as the primary reason for a decline in the success rate as it relates to the fight against the disease. He revealed that last year’s efforts realised a mere 64 percent success rate when in fact the aim was somewhere in the vicinity of 90 percent.
In addressing the problem, Dr Lall said that efforts are being made to even screen pregnant women to ensure that if they have TB, every precaution is taken to ensure that they do not pass it on to their unborn children. They are also screened for HIV at the same time, Dr Lall said.
The fact that some doctors who have been trained to address pulmonary conditions have been leaving are also factors hampering the desired success of the fight against TB, he added.
Dr Lall, who has spent close to four decades addressing pulmonary conditions and diseases, revealed that over the years he had trained quite a few doctors, some of whom have since left the system.

Dr Moti Lall

“Presently we have doctors who are working with the National TB programme but who, in my opinion, should be provided with post-graduate programmes. I think more and more people should be trained because AIDS is increasing and so is TB as a result and we have to address this… “
“Stop TB is the motto for this year so we are out to stop it in the true sense. I am in this programme since the 1960s and inasmuch as I am not in the public health system, I realise that the bottom-line is that there is need for more money and more training.”

DOTS Programme
With the main intent being to provide a set of directions to strengthen the health system and decrease mortality and morbidity due to Tuberculosis (TB), the local Health Ministry has been working towards ensuring that its DOTS services are sustained and improved Chief Medical Officer, Dr Shamdeo Persaud has asserted. In the year 1994 Guyana established DOTS, a programme whereby health workers visit all registered TB patients and ensure that they take their treatment as recommended. The improvement of the DOTS programme is detailed in the Ministry’s 2008-2012 Strategic Plan which has as its ultimate goal to decrease the incidence of TB in Guyana. According to Dr Persaud the Strategic Plan serves to outline policies, principals, strategies and programmes of the national response to tuberculosis control in Guyana for the stipulated period. He has noted that the plan links the objective of the Millennium Development Goals (MDGs) of the United Nations, the National Development Strategy (NDS) of Guyana and the Poverty Reduction Strategy Paper with the National Health Sector Strategy of Guyana.
The 2008-2012 Strategic Plan represents the second of its kind which evolved out of a previous plan which was developed in 2001 and implemented during the period 2002 through 2006 with support from the Canadian International Development Agency (CIDA). Dr Persaud has noted that that plan had further benefited from the main goals and objective of the World Health Organisation (WHO) ‘Stop TB’ partnership and the Pan American Health Organisation Regional Plan for TB control in the Americas. The current Strategic Plan, according to the doctor covers the critical strategic issues relevant to organisation and decentralisation of the services for early detection, adequate treatment, supervision, monitoring and evaluation of TB.