OpenForum – a blog by the Health and Human Rights community

Two new studies suggest promising methods of detecting and treating TB despite discouraging reports about the increasing global prevalence of multi-drug resistant tuberculosis (MDR-TB) and extensively-drug-resistant tuberculosis (XDR-TB). The first study underlines the importance of follow-up visits in detecting TB among immigrants and asylum seekers entering the US. While screening is crucial in preventing the spread of TB, identifying TB-infected persons can be difficult; blood or sputum smear testing can take weeks to complete and has only a 50% accuracy rate. Screening of immigrants and asylum seekers is especially important, as the TB rate in foreign-born persons is 9.7 times higher than in US-born persons. Researchers found that follow-up visits with immigrants after their entry into the US were effective in identifying and reducing the number of TB patients in the US.

The World Health Organization estimated 9.27 million cases of TB in 2007, a significant increase from 6.6 million cases in 1990. The majority of these cases are found in the South-East Asia region, which accounts for 34% of all new cases, and sub-Saharan Africa, which has the highest TB mortality rate in the world. People with health conditions that weaken the immune system like HIV infection, substance abuse, or malnutrition are more susceptible to the disease. A recent study showed that one-fourth of all TB-related deaths were in patients who were also HIV-positive.

No new classes of TB drugs have been created since the 1960s, and few clinical trials have been conducted using modern regulatory standards. To address this need, research groups are focusing on novel approaches to TB therapeutics. The Global Alliance for TB Drug Development (TB Alliance) recently announced four research partnerships that will explore new methods of treating drug-resistant TB. One of these collaborations, led by Anacor Pharmaceuticals, will provide any new compounds developed to the TB Alliance royalty-free. Read more

The non-profit organization, Physicians for Human Rights (PHR), published a report in January of 2009 on the cholera outbreak and related health crises in Zimbabwe. Outlining the outbreak in painful detail, the report suggests that the scope of the disaster, largely due to government mismanagement and neglect on a national scale, constitutes crimes against humanity.  PHR thoroughly examined the wide-spread public health crisis in the context of the 28 year rule of Robert Mugabe and urges further investigation and involvement from the international community and possibly the International Criminal Court.

Article 7 (1) (k) of the Rome Statute of the International Criminal Court describes crimes against humanity to include “other inhumane acts of a similar character intentionally causing great suffering, or serious injury to body or to mental or physical health.” Zimbabwe is not a signatory of the Rome Treaty.  However PHR asserts that crimes against humanity, as defined by the Rome Treaty, are within the bounds of customary international law. Because Zimbabwe has disregarded the epidemic and openly blocked international aid resulting in the deaths of thousands, PHR believes this constitutes a crime against humanity.

The situation in Zimbabwe dire. During August of 2008, the country saw the beginning of a cholera outbreak that the World Health Organization has categorized as “explosive.” Cholera is easily treated with fluids administered orally or intravenously while the infection runs its course. Without this simple intervention, cholera leaves its victims with severe dehydration that can lead to death. An update published by the World Health Organization on February 20, 2009 listed nearly 80,000 cases and almost 4,000 as recorded by Zimbabwe’s Ministry of Health and Child Welfare (MoHCW). The WHO did provide some encouraging data as it estimated the epidemic peaked in November of 2008. Read more