Pakistan ranks fifth globally in the number of tuberculosis (TB) cases and fourth for drug-resistant TB, a concerning development particularly affecting children and young women, warned Sindh Health Minister Dr Azra Fazal Pechuho.
Pakistan, with an estimated 510 000 new TB cases emerging each year and approximately 15 000 developing drug resistant TB cases every year, is ranked fifth among B high-burden countries worldwide and it accounts for 61% of the TB burden in the WHO Eastern Mediterranean Region.
The country is also estimated to have the fourth highest prevalence of multidrug-resistant TB (MDR-TB) globally. Key reasons for emergence of drug resistance form of TB include: delays in diagnosis, unsupervised, inappropriate and inadequate drug regimens, poor follow-up and lack of a social support programme for high-risk populations.
In line with the WHO ‘End TB Strategy’ the national TB control programme has developed a national strategic plan 2017–2020 with innovative methodologies, expanding partnerships, and multisectoral approaches by engaging all stakeholders.
The Global Fund is the main donor support, with US$ 154 million available under ‘New Funding Model’ for 2016–2017. The Global Fund grant, is being implemented through public sector and two private sector (Indus and Mercy Corps) Principal Recipients with provincial TB programmes and other private SRs, providing direct costs of anti-TB programmes and services, which leverages the existing massive government infrastructure and human resource.
WHO, along with other developmental partners including STOP Tuberculosis, are providing support to the national and the provincial TB control programs, in capacity-building on latest WHO diagnostics and treatment guidelines, programme evaluation, technical support for the management of MDR-TB, resource mobilization and support for research and development.
The National TB Control Programme, under Ministry of National Health Services, Regulation and Coordination is primarily responsible for collaboration for development of uniform policies and strategies, facilitating the donor liaison at national and international levels, and Global Fund grant management. Along with the public sector, private sector and civil society and community based organization, are playing a vital role in case detection and management of TB, in the country.
Speaking at the ceremony, Dr Pechuho emphasised that Baldia Town has emerged as a hotspot for TB within Keamari district, with a significant increase in child mortality linked to the disease. "TB is a curable disease if diagnosed early, treated properly, and if patients strictly follow the prescribed antibiotic regimen," she added.
"However, misuse and premature discontinuation of antibiotics have led to the emergence of drug-resistant TB strains, forcing reliance on 'last line' treatments. If resistance to these critical drugs develops, it would pose a grave threat."
Dr Pechuho stressed that TB can affect not only the lungs but also the liver, brain, bones, and other vital organs, particularly in children. She urged the public to avoid panic, seek medical advice from qualified doctors, and complete their full course of treatment to curb the spread of the disease.
Highlighting the broader implications, she noted that drug-resistant TB cases are becoming increasingly common and require urgent collective efforts to control. "The initiative taken by MSF in Baldia Town is commendable. Their mobile medical services are also operational in other parts of Karachi, significantly enhancing healthcare outreach," she added.
MSF Project Coordinator Albina said the newly inaugurated clinic represents more than just a healthcare facility-it marks a collective commitment to improving health services. The clinic's establishment was made possible through collaboration with the Centres for Disease Control and Prevention (CDC) and the Sindh Health Department.
