A case of priority

PUBLISHED : Monday, 14 July, 2003, 12:00am
UPDATED : Monday, 14 July, 2003, 12:00am

There is little point in going to the effort and expense of stamping out a rampant infectious disease if its spread does not directly affect the economy.

Judging by the way tuberculosis is half-heartedly dealt with on the mainland, that would seem to be the prevailing view of the authorities here.

Tuberculosis is China's most deadly infectious disease, killing more than 250,000 people every year. Six million people carry the disease, 2 million of whom are infectious. The Sars virus pales in comparison, with 5,327 infections on the mainland and 348 deaths.

TB, like Sars, is spread by infectious droplets, through coughing, sneezing or spitting. The majority of tuberculosis victims die because they cannot afford adequate health care. Poor nutrition, an unhealthy living environment and a lack of knowledge about the disease also help it flourish. It thrives in conditions of poverty and overcrowding, with infection rates in poor rural areas three times higher than in urban areas.

The disease cuts people down in their prime, with three out of four deaths occurring between the ages of 15 and 54. By killing the breadwinners, its effects reverberate through impoverished communities.

As dire as things are, the signs are they will get worse. Health experts have warned that if radical preventative measures are not taken soon, more than 200 million Chinese could be infected in the next 10 years with mycobacterium tuberculosis, the bacterium that leads to TB, and up to 10 per cent of those could develop the fully fledged version. The death rate on the mainland is exacerbated by the Aids epidemic, as people with HIV have lowered immunity and contract TB more easily.

The fact that it is easy to prevent and treat tuberculosis would be news to many sufferers in rural China. Cheap vaccines and basic medical treatment are still beyond the reach of the silent majority. To contain TB, the World Health Organisation recommends a strategy known as directly observed treatment, short-course. This plan involves finding and curing infectious TB patients and ensuring that they receive free care and that they take a full six-month course of treatment.

Several regional initiatives of this kind have been launched in recent years on the mainland and have been enormously successful. But as the figures clearly show, they have only scratched the surface.

Authorities have long said they have not got the resources to launch an orchestrated campaign to eradicate the killer. But that rings hollow after the Sars crisis. The world has seen what the government can do once it identifies a priority. A nation was mobilised, resources were freed up, Sars was curtailed.

But there are no signs of any mass campaigns being launched to save the millions of tuberculosis sufferers. Unfortunately for them, there is no correlation between their unnecessary deaths and the levels of foreign direct investment that flow into the country.