$800m funds new war on TB

A World Bank loan of US$104 million (HK$809 million) will fund a new war on tuberculosis, expanding on an 11-year-old plan that provides the poor access to clinics that can accurately diagnose and treat the disease.

Supplemented by a US$37 million grant from the British Department of International Development, the programme will help provide rural clinics with X-ray machines and microscopes, and provide the most needy patients with free, short-term chemotherapy treatments that can cure the disease.

'Compared with a developed country, health care in China is still affordable enough that we can see great improvements in the population's health by investing a relatively small amount of money,' said Austin C. T. Hu, deputy chief of the World Bank's China mission.

Mr Hu said tuberculosis was China's most deadly infectious disease, annually killing about 260,000 of the six million carrying the active disease. And with 400 million people carrying TB antibodies - which shows they have been exposed to the disease - China has the world's highest number of TB carriers, after India.

While the 1991 project was heralded by the World Health Organisation as one of the most successful TB interventions, bank and government officials feared they would have failed to create a sustainable initiative if the project ended this summer, as planned.

'Ninety-five per cent of those infected with TB can be cured with a full course of chemotherapy. But people who curtail treatment because they can't afford it develop a multi-drug resistant form of TB that ultimately costs 100 times more to cure, with only a 60 per cent success rate,' said Wang Shiyong, the World Bank's health director in Beijing.

Mr Wang said the central Government identified Xinjiang, Gansu, Shanxi, Shaanxi, Inner Mongolia, Guizhou, Guangxi, Henan, Hubei, Hunan, Hebei, Liaoning, Fujian, Jiangxi and Jilin provinces and Chongqing as primary recipients, but said the bank had no restrictions on where the money could be applied.

According to Mr Hu, China's TB death rate is exacerbated by its Aids epidemic, as people with HIV have lowered immunity to TB, making it easier to contract and turning carriers into full-blown sufferers.

'The proportion of HIV-positive people who die of tuberculosis is a very small number in developing countries. But in China, one-third of people with Aids will ultimately die as a result of tuberculosis,' Mr Hu said.

The Government initiated its own TB control project in 1993, but World Bank officials said it had seen a much lower patient-cure rate because the programme was not free, providing only accurate diagnoses to those who could afford them.