Urgent need for TB campaign - health ministry

Health authorities are concerned that since independence, Tajikistan has had no national campaign to vaccinate school aged children against tuberculosis (TB) - a disease that is in danger of reaching epidemic proportions in the impoverished Central Asian state. "Although a national programme on TB prophylaxis has been adopted, this has not been enacted primarily due to lack of funds to purchase the vaccine," Sokhibnazar Turkov, deputy director general of the Centre of Immunoprophylaxis, told IRIN in Dushanbe on Tuesday. Tajikistan is about to embark on a nationwide US $3 million programme to immunise the population against measles, that far fewer Tajiks suffer from. The measles campaign is being supported by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). Turkov said he was conscious of the health problems posed by TB, but that different diseases needed different approaches. The whole world aspired to get rid of measles and therefore the support of WHO and another organisations was there to launch mass eradication campaigns in developing countries. "Tuberculosis is another kind of infection, we won't overcome this disease until we raise the standard of living of the whole population." According to the Tajik TB Control Centre, officially registered new cases of TB amounted to 55 per 100,000 of the population in 2001. In 2002 that figure rose to 64, and went up to 67 in 2003. The TB mortality rate stood at 7.1 cases per 100,000 in 2003. The population of Tajikistan is some 6.5 million. Increases in TB infection rates are connected with the deterioration of social and economic conditions in the country since independence and with the breakdown of the Soviet system of health care. For several years there have been no regular checkups of school children and in children's institutions, health officials said. "This disease [TB] poses a serious problem, both to the state and society. According to the National TB Control Centre, between 2,800 and 3,500 new cases of TB are registered each year in Tajikistan, and this trend continues to go upward," Nazira Artykova, a liaison officer for WHO, told IRIN. Turkov added that Tajikistan was often not able to choose which infections to fight, as it is a vaccine-dependant country. "What we are granted we use. Now we have the vaccines against TB for two-year-old children only." Effectively combating TB requires regular vaccinations of children over a number of years. High local TB rates are also related to massive labour migration to Russia, where many Tajiks are forced to live in squalid conditions on a poor diet - ideal conditions for the disease to flourish. Civil war in the 1990s and political instability have also prevented Tajikistan from embarking on mass TB vaccination programmes targeting the most vulnerable. Donor support for TB campaigns in Tajikistan is growing. "Now there is increased attention to TB in the whole region, and here in Tajikistan," Tom Mohr, the programme manager for the international NGO Project Hope, said. Development workers believe that with improved stability and security, donors are more confidently investing in longer-term and more diverse programmes. Such programmes are important as even an uncomplicated case of TB can take up to nine months to treat.