International Aids Conference: 'Twin epidemics' warning as TB is unleashed

TWIN EPIDEMICS of Aids and tuberculosis are set to ravage Asia, with TB deaths overtaking those on the African continent by 2000, the World Health Organisation warned yesterday, writes Liz Hunt.

Dr Arata Kochi, head of its TB programme, told the Aids conference: 'TB and HIV are feeding off each other at an alarming rate . . . TB is now responsible for almost 2 million deaths in Asia each year. As these two epidemics meet - the destructive power of both will increase. In effect, HIV is unleashing a whole new cycle of TB infections.'

HIV-positive people infected with TB are 30 times more likely to get sick than a HIV- negative person who carries TB. The disease also hastens death from Aids.

The organisation predicted that by 2000, 639,000 Asians will contract TB each year as a result of being infected with HIV. This will account for 10.3 per cent of all Asian TB cases, up from 1.7 per cent in 1990. Of these, an estimated 224,000 will die, overtaking deaths caused by the dual infection in Africa, now the worst-hit continent.

Dr Kochi said that most Asian governments have yet to respond to the crisis with effective TB programmes.

World-wide, the organisation expects the number of people with TB to increase to 10.2 million in 2000, up from 7.5 million in 1990. By 2000, 13.8 per cent of the cases will be due to dual infection, up from 4.2 per cent in 1990. A year ago, the organisation declared TB a global emergency which will claim 30 million lives within the next decade unless governments act now.

World-wide, the disease is the leading cause of death from a single infectious agent, although drug cures are cheap.

Most cases occur in developing countries but there has been an upsurge in industrialised countries since the mid-Eighties, because of to rising poverty, homelessness, immigration, and drug misuse. The appearance of drug- resistant forms of the bacterium in the US have caused particular concern. New York is experiencing a TB epidemic.

In Britain, the decline in TB stopped in the late Eighties when it was running at 6,000 cases annually; about 7,000 are now being reported. In July last year a TB centre opened in east London to cope with one of the highest incidences of the disease in Britain due to poverty and the large number of immigrants. In Tower Hamlets, 50 people per 100,000 are infected, about 10 times the national average.

A tamed disease, page 19