Meena (name changed), a 35 years old mother of 3, comes from a village in district Gonda of Uttar Pradesh, India. She is living with HIV and has suffered from TB also. I met her at the antiretroviral therapy (ART) centre of a Government Hospital in Lucknow and was instantly struck by her infectious smile and cheerful disposition. Three years ago, both she and her husband were diagnosed with HIV. She was immediately put on ART, but not her husband as the doctor did not find his CD4 count below the critical level. Ironically, her husband died six months later of a fall, but Meena is still up and about.  She has completed a two years anti-TB treatment regimen which was started alongside ART. Initially she bought the TB medicines from the private market spending around Rs 3500 (approximately USD 70) a month. Later on she started getting them for free from a government hospital. Every month she travels a distance of 150 km to Lucknow to collect her ART medicines. Luckily her children are all HIV negative.

The recently released fourth annual edition of the financing series of the Institute of Health and Metric Evaluation (IHME), ‘Financing Global Health 2012: The End of the Golden Age?’ tracks Development Assistance for Health (DAH) from government aid agencies, multilateral donors, and private foundations. It also analyses health spending from governments in developing countries between 1990 and 2010. By combining health funding estimates with the results of the newly published Global Burden of Disease (GBD) Study 2010, the report provides metrics that can help inform donor priority setting. Comparisons between the amount of DAH that a country receives and its disease burden provide useful tools for assessing need versus funding.

The Cochrane analysis represents the most comprehensive review on the diagnostic accuracy of Xpert and provides evidence that may help countries make decisions about scaling up Xpert for programmatic management of TB and drug-resistant TB.

Well, perhaps yes. While talking to Citizen News Service - CNS at the 43rd Union World Conference on Lung Health in Kuala Lumpur Mark Harrington, Executive Director of Treatment Action Group (TAG), wondered why we are doing better in responding to HIV, which was discovered only in 1981 and for which there was no effective treatment until 1996, while we are losing the battle against TB which was discovered in 1882 and the first drugs for it came in 1948. He rued the fact that we are falling short of meeting the targets for controlling TB and reducing mortality from TB by 50% by 2015 as compared to 1990.”

An unregulated and greedy private sector and an inefficient and under- funded public sector in India generously allows its patients to choose between the devil and the deep seas. According to the National Family Health Survey-3, nearly two-thirds of all households (70% in urban and 63% in rural areas) in India generally seek health care from the private medical sector, while only one-third of households use the public medical sector. The most common reason given for not using public sector health care facilities is poor quality of the service, followed by non-availability of a facility nearby, long waiting time, and inconvenient hours of operation. This is a clear indication that India's public health delivery infrastructure fails to protect the interests of vulnerable groups.

Dr Manoon Leechawengwong, is the chairman of the Drug Resistant TB Research Fund at Bangkok’s Siriraj Foundation and is also the Immediate Past President of Thai AIDS Society-- His foundation is under the patronage of the King’s sister--The Royal Highness Princess Galyani Vadhana Krom Luang Naradhiwas Rajanagarindra. He recently spoke to CNS in Bangkok about the rising problem of multi drug resistant TB (MDR-TB) in Thailand. Dr Manoon believes that drug susceptibility testing (DST) is the first crucial step in managing drug-resistant TB. It is a necessity, and not a luxury, to do culture testing for all TB patients, to help guide the physicians to select the optimal anti-TB medicines. However, a major barrier to controlling MDR-TB in Thailand (and elsewhere too) is the lack of cheap, rapid and accurate diagnostic test methods. Dr Manoon’s hospital has a cheap technique to detect MDR-TB at the cost of USD 4-5, provided AFB (Acid Fast Bacilli) is smear positive.

Dr Nils E Billo, has been Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union) since 1992 when it was a very small organization with just about a dozen staff and consultants, who focused on tuberculosis. During this long stint, spanning over two decades, Dr Billo has been instrumental in helping the Union grow from strength to strength—from a fledging federation to a leading international health organisation, with more than 10,000 members in 152 countries, and some 300 staff and consultants working from Paris and other offices in 11 countries. The Union's mandate has expanded and gone beyond tuberculosis and lung disease to include other public health issues as well, such as child lung health, HIV/AIDS, the pandemic of diseases caused by tobacco use and the rise of non-communicable diseases (NCDs). In this interview, given exclusively to Citizen News Service - CNS at the 43rd Union World Conference on Lung Health, Dr Billo talks about what has changed in the world of TB over this period of twenty years, and the current problems impeding efforts to eradicate this dreaded disease which, despite being curable, takes a huge toll of human lives.

Thailand is one of the 22 TB high burden countries in the world. According to the WHO Global Tuberculosis Report 2012, Thailand, with a population of 70 million, had about 86,000 TB incident cases and 110,000 TB prevalent cases in past year. Case detection rate for all forms of TB was 76% and treatment success rate was 85% (in 2010).

It seems so. Close to the heels of the WHO Global Tuberculosis Report 2012 releasing some data on childhood tuberculosis for the first time, one plenary at the recently concluded 43rd Union World Conference on Lung Health in Kuala Lumpur was dedicated to ‘Childhood TB: We need to do more’. Childhood TB (CTB) is finally on the public health agenda and children are now being recognized as a vulnerable group in the field of TB. The increase in childhood TB is an indication of the failure of the control of TB epidemic and an indication of household TB dynamics, as well as the emergence of transmitted Multidrug Resistant (MDR) TB. The disease presents itself with high (albeit preventable and treatable) morbidity and mortality in the youngsters. An estimated 490,000 children are falling ill with TB every year and 200 are dying of it every day (the actual numbers would be much more).

The association between tuberculosis - TB (a communicable disease) and diabetes (a non-communicable disease) and their synergetic role in causing human suffering has been recognized for centuries but recent studies have undoubtedly established a more direct link between the two. Realizing the gravity of the problem, the WHO issued a policy statement his year, on what needs to be done to address TB-diabetes co-infection. The urgent need to address the comorbidity of these two diseases received serious attention at the recently concluded 43rd Union World Conference on Lung Health in Kuala Lumpur.