A global rise in drug-resistant tuberculosis is threatening millions of the world's poorest people, it was claimed today.

A global rise in drug-resistant tuberculosis is threatening millions of the world's poorest people, it was claimed today.

The World Health Association was launching a major report which shows drug-resistant and multi-drug resistant TB is on the rise.

And the disease is moving from developing countries to Russia and Europe, it was revealed.

The study was being published on International TB Day, designed to raise awareness of growing rates of the disease.

Homeless charity Crisis warned that people living on the streets were most at risk of TB in Britain.

The charity said homeless people were 25 times more at risk of TB than the average person.

Figures from shelters run by Crisis over Christmas suggest that one in 33 homeless people is suffering from the disease.

Crisis chief executive Shaks Ghosh said: "Many homeless people are lucky to see a GP once a year so it is no wonder their health is suffering so badly.

"The situation is appalling and we cannot allow it to get any worse. Health services need to work closer with homeless agencies to make sure that people get treatment fast for this life-threatening disease."

And public health officials in China today warned that tuberculosis is so widespread there that it is slowing the country's economic development.

There are 500 million Chinese infected with tuberculosis, 6 million of whom are ill with the disease and 2 million of whom are contagious, the China Health News and other newspapers reported.

Some 41 per cent of tuberculosis patients in China suffer from drug-resistant strains that are spreading rapidly in China and other regions due to inadequate treatment and poverty, the reports cited Yin Dakui, vice minister of health, as saying.

He noted that losses caused by tuberculosis were severe since most patients are of working age.

"Hardly any other disease can cause direct damage to families and hinder social and economic development more than TB," the China Daily quoted Yin as saying.

China ranks second in the world after India in the number of tuberculosis patients. Each year, the disease kills 250,000 people here.

Health officials worry that the scant progress they have made may be lost once funding ends in June 2001 for a World Bank-assisted project to combat the disease in cities and provinces inhabited by 560 million people.

The program, called "Directly Observed Treatment, Short-course," or DOTS, provides free treatment, an uninterrupted supply of good quality drugs and monitoring to ensure that patients who are partially cured do not stop treatment. Partial treatment often leads to the development of drug resistant strains of the disease.

The DOTS project resulted in a 90 percent cure rate for the 1.5 million tuberculosis patients it treated, the report said.

Migration has also aided the spread of the disease, which is far more prevalent among rural dwellers lacking access to health care than among urbanites. According to a report by the People's Liberation Army Hospital No. 309 in Beijing, 87 percent of patients hospitalized with tuberculosis were migrants and the rate in infection with drug resistant strains was higher.

The spread of the HIV virus and AIDS was also causing co-infections and fanning the epidemic, the reports said.

The government plans a nationwide survey on the disease this year and intends to extend the directly observed treatment strategy to cover 90 percent of the population by 2005, the China Daily said without explaining details on funding.

Tuberculosis damages the lungs and, if left untreated, can attack other parts of the body such as the intestines and joints. Throughout the world 1 to 2 million people die each year from the disease, about 95 percent of them in developing countries.