Bangladesh’s tuberculosis control programme is facing new challenges with the shrinking of global funds to fight this infectious disease and rapid urbanisation, experts say.International reviewers have advised Bangladesh to reduce donor dependency for the tuberculosis control programme as global funding will be cut in the new sustainable development agenda.Due to paucity of funds, NGOs which are implementing the government’s programme on the ground are currently laying off their field workers.“We’ll not be able to retain 40 percent of our field staff,” Dr Mohammad Hossain, HIV & TB advisor of the Surjer Hashi of the USAID-DFID NGO Health Service Delivery Project, said at a discussion on Thursday.He suggested finding new approaches, such as involvement of community groups to help patients complete the lengthy six months’ drug course.TB has been successfully controlled through this directly observed treatment method (DOT) in which a health worker keeps watch on a patient taking the pills.A failure to adhere to the six-month drug regime can lead one to life threatening drug-resistant TB.Dr Hossain, after the discussion at BRAC, explained to bdnews24.com that “if one worker follows 10 patients then we need at least 20,000 such workers as we have detected 200,000 new cases now.“The number of case detection will increase. So, it’s difficult to do this job with a single health worker. Global focus has shifted elsewhere with the new development goals. TB is still on the agenda, but not getting as much focus as it used to”.He said many countries had involved family members, and people from their neighbourhood for the DOT.“Anyone can be a provider (of the drug). But we must have such policies at the national level.
We just have to train people,” he said.WHO National Professional Officer for TB Dr Vikarunnessa Begum acknowledged the new challenge and said community clinics could be involved in this process.“We can introduce this (DOT) at every community clinic. It’s just a matter of a government order. This will assist patients get well quickly,” she said.Line Director of the government’s TB Control Programme Dr Md Mozammal Haque told bdnews24.com that the authorities were aware of the new challenges.“We have made all preparations. Our programme will run smoothly,” he said.He said the government was also trying to continue DOTs with the help of local people as well as family members in some areas where NGOs do not have staff.“But nationally we have not taken any decision,” he said.Dr Md Akramul Islam, director of TB, Malaria and WASH Programme at BRAC, urged the government not to lose focus on tuberculosis.He said with the economic development, cities would be the “epicentre” of TB as has happened in Yangon, Bangkok, Hanoi, and even in Japan’s Osaka.“Crammed into small houses with no ventilations, the urban poor can spread infections easily,” he said.“We have to take up programmes focusing on such factors,” he said.The National TB Programme, BRAC, and the Bengali daily Ittefaq jointly organised the discussion.