(SEOUL) – The revocation of a major international aid organization threatens to leave tens of thousands of tuberculosis patients in…
(SEOUL) – The revocation of a major international aid organization threatens to leave tens of thousands of tuberculosis patients in North Korea without the medication they need and can spiral in a serious crisis if not treated soon, according to health experts familiar with the situation in the north.
The staggering stock of important drugs follows the Global Fund for Combating AIDS, Tuberculosis and Malaria, an international aid organization whose contribution to North Korea supported the treatment of 120,000 TB patients each year. Its support officially ended in June despite the screams among healthcare officials in North Korea and in the international community that it could spark a major epidemic.
Neurosurgeon Kee Park, of the Global Surgery and Social Change Program at Harvard Medical School, said in an email to The Associated Press that the situation is extremely sharp and is likely to be dramatically worse in the coming years if it is not treated properly.
The US based non-profit Eugene Bell Foundation, working on the field treating tuberculosis in North Korea, said Friday that the crisis is being strengthened by US-led sanctions on Pyongyang’s nuclear and missile programs.
North Korea has one of the world’s highest tuberculosis levels, a highly infected disease globally treated, causing more than 1
million deaths each year. According to the World Health Organization, approximately 107,000 cases of tuberculosis were reported in North Korea in 2017. To make matters worse, North Korea has estimated that 6-7% of its tuberculosis population has the drug-resistant variety, known as MDR-TB, which is much more difficult and expensive to cure.
“As a result of the loss of global funds contributions to North Korea, we expect a reduction in treatment capacity for patients with non-MDR-TB treatment by 50-75%,” Park said. “Our model therefore calculates between 155,000 and 210,000 more people will die of TB-related causes within five years. To be clear, new deaths are expected beyond today’s mortality. We have assumed that MDR-TB treatment will Continue at current levels. “
Drug-resistant tuberculosis usually results from patients who do not take the right amount or combination of drugs to completely cure them from the disease or by coming into contact with someone who has already been infected.
There are frequent populations who have had some exposure to TB drugs, for example. cities or other places with populations that are relatively more prosperous – or at least wealthy to pay
Pyongyang, the North Korean capital, is believed to have a particularly large presence of the drug-resistant TB strain.
The Global Fund announced in February that it closed its contributions to North Korea, effectively ending the largest public health aid program ever in the north due to insufficiency and difficult operating conditions. It has said that its stock would last for a year, which is longer than the average 6- to 9-month treatment rate for a TB patient.
But the worry is about what will happen after that, how new cases can be treated if nobody comes in to fill the gap and whether the limited medication pool should be “ransoned” in a misguided effort to spread which medicines left .
“Time is ticking,” said Park. “I’ve heard from people who have been inside recently that the rationing has already begun.”
The problem is particularly acute because North Korea has a fragile public health system that can easily be overwhelmed by a major outbreak and sends North Korea’s streaming across the country’s border with China, making the epidemic a major regional issue.
Concerned about such a disaster led to the north essentially closing the borders during the Ebola horror 2015 and during the 2003 SARS outbreak in China, but neither seemed to be a major threat to the isolated north.
Stephen Linton, chairman of the Eugene Bell Foundation, told reporters in Seoul that South Korea lacks the urgency of helping groups to get their sanctions exempted so that they can deliver deliveries to treat patients in North Korea.
He liked the problem of having the house next to the door saying that North Korea’s tuberculosis problem could have health consequences for South Korea.
Linton said he believes that Global Fund’s decision was at least partly associated with sanction-related pressure. The US government, which promised $ 1.4 billion this year, is one of the largest donors to the Global Fund.
He noted that it has also become harder for US aid workers to get permission to travel to the north since President Donald Trump announced his ban on US citizens more than a year ago.
Choi Seemoon, an Eugene Bell director, said that while Eugene Bell and Global Fund have delivered MDR-TB drugs to around 2,000 patients this year, less than 30% of estimated 8,000 North Koreans qualify. Global Fund’s stock of regular tuberculosis medication will end in early 2020, she warned, while its MDR-TB medication can only cover patients registered in the fall of this year.
“There must be a quick purchase of medicines and deliveries to overcome the void left by Global Fund,” Choi said. “If the problem resolves through interkorean talks or through international organs and non-state channels, there should be a fast delivery of tuberculosis medicine to North Korea, no matter what channel it takes.”