Academician Perelman’s cure for TB: no wars, immigration or poverty

At a press conference at RIA Novosti on World Tuberculosis Day, Luigi Miglorini, special WHO representative, discussed the search for new ways of combating the disease.  He stated that the problem of tuberculosis (TB) affected about one third of the world’s population (about 2 billion people). Although in the past the disease had mainly spread in developing countries there had been a tendency in the last decade for the problem to increase in richer countries.  He attributed this to the increase in people with HIV infections who were more susceptible to tuberculosis than those with unimpaired immunity.  Academician Perelman, tuberculosis specialist at the Ministry of Health and Social Development, maintained that the development of TB was 80% due to social and economic factors and only 20% due to the state of health and medicine. In his opinion the most important step was disease prevention, since treating it was long and difficult.

According to official data from the Ministry of Health and Social Development, 240 000 Russians are examined daily for TB, of whom 320 have the disease confirmed. 72 Russians die every day from TB, a further 240 patients recover and 24 stop the treatment they started.  According to Lyudmila Mikhailova from the Ministry of Health and Social Development, patients cutting short treatment is a major problem, since this leads to multidrug-resistant TB, which is much harder to cure.  According to Alla Kuznetsova from the Federal Penitentiary Service (FSIN), an anti-tuberculosis service has been created in FSIN with the help of a loan from the International Bank of Reconstruction and Development and resources from the Global Fund, with the acquisition of laboratory equipment, photofluorography units and pharmaceuticals. However, the resources of the Medicosanitary Service of FSIN remain inadequate, which is one of the problems in treating TB for those in prison. The other problems concerning doctors working in the penitentiary service include the shortage of TB specialists in FSIN, the lack of a single computer database of patients in Russia, the lack of continuity between the prison and civil health care systems and the lack of help centres for those released from detention, so that they suffer from a further progression of the disease.  Kuznetsova also stated the need for a federal law on the compulsory treatment of the active form of TB.  Prisoners regularly refused to take drugs voluntarily, justifying this on the grounds that those who were ill could count on an early release.  As a result only half of those released from detention went to medical centres and the remainder continued to infect those around them. According to federal statistics more than 262 000  people in 2009 were suffering from active tuberculosis. Despite these problems it was vital to try and overcome this disease in Russia, according to Academician Perelman. As a first step children should be vaccinated and there should be mass screening of the population using photofluorography, where with modern equipment the radiation dose could be reduced to a minimum.

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