Mar07-3-1

GENEVA (Reuters) - Eradicating tuberculosis could take centuries without better drugs and diagnostics for the contagious disease and its deadly new strains, United Nations health officials said on Thursday.

Nearly 9 million people caught tuberculosis in 2005 and 1.6 million died of it, about the same as the year before, which showed that containment efforts were working, the World Health Organization (WHO) said in a report.

But reducing the number of new cases will be "extremely slow" unless health workers get access to new tools, said Mario Raviglione, director of the WHO's Stop TB Department.

"If we go on with this type of pace, then it will take centuries to eliminate TB," he told a news conference in Geneva.

One-third of the world's population is infected with the microbes that cause tuberculosis, a largely curable respiratory disease that spreads like a common cold.

Only 10 percent typically get sick and those with weakened immune systems are most vulnerable.

It is the top killer of those with HIV, causing 200,000 deaths a year. Faster and more reliable tests could save lives and prevent its spread among vulnerable groups, said Peter Piot head of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Africa's large HIV population is at special risk from a particularly deadly new strain, known as XDR-TB, which has been discovered in 28 countries worldwide since last year.

"There is an urgent need to invest far more in research for new and more effective ways to diagnose TB," Piot said.

Humanitarian group Medicins Sans Frontieres (MSF) said drug resistance added to the problems and made it very difficult for health workers to control tuberculosis in some areas.

"In places where we see a lot of HIV/AIDS, the risk of (drug-resistant tuberculosis) spreading like wildfire is a terrifying but all too likely prospect," said Liesbet Ohler, a doctor with MSF's program in a slum near Nairobi.

The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), which represents 25 firms and 46 industry groups, said its members were researching 17 tuberculosis drugs, and six were in clinical trials. Two tuberculosis vaccines were also in early-stage trials, it said.

MSF said none of the compounds in the research pipeline showed promise in shortening the tuberculosis treatment course, which can last years, and the diagnostics being developed were not simple enough to detect tuberculosis in difficult settings.

Deadly TB strain seen in Africa now in rich nations

UNITED NATIONS (Reuters) - A new deadly form of tuberculosis spreading through South Africa has now been found in rich nations in Europe as well as Canada and the United States, the World Health Organization said on Thursday.

Africa's large AIDS population is at special risk from the particularly virulent strain, known as XDR-TB (extremely drug resistant), which had been documented in 35 countries worldwide, 16 of them this year alone.

"This is an the most urgent thing I have seen in my 15 years of working on tuberculosis," Mario Raviglione, director of the STOP TB program at the World Health Organization. He introduced WHO's TB report, which coincides with the 125th anniversary of the discovery of the microbe that causes TB.

"If it keeps spreading, as it has in South Africa, then we are really in trouble, Raviglione said.

To commemorate World TB Day, Anna Cataldi, an Italian author and U.N. peace messenger, organized a photo exhibit of TB victims by award-winning photographer Jim Nachtwey and spread banners around Manhattan on fighting the disease.

Some 2 billion people worldwide live with TB, an airborne illness that is normally treatable through inexpensive medication. But if the disease is not diagnosed and treated, it can mutate into drug-resistant strains.

In 2005, nearly 9 million people caught tuberculosis and 1.6 million died of it, about the same as the year before, which showed that containment efforts were working, Raviglione said. The epidemic is centered primarily in Asia and in Africa, which accounted for 84 percent of the total.

"The good news is that the global incidence may have peaked," particularly in China, India and Indonesia, he said. "The bad news is that although the incidence has declined (there) is resistance to most powerful first-line drugs and a form of TB that is resistant to second-line drugs."

There are 269 confirmed cases of XDR, first reported in South Africa, with 85 percent of the afflicted expected to die.

Raviglione said the new strain was spotted in rich nations also, such as the United States, Canada, France, Ireland, Israel, Italy, Sweden, the former Soviet Union and elsewhere.

In the industrialized nations, XDR-TV increased from 3 percent to 11 percent in 2005, WHO said without giving precise numbers of victims.

A cure is not available. As a first step, diagnostics and improved health systems are deemed necessary to treat HIV, the virus that causes AIDS, and TB simultaneously.

Drug company Eli Lilly is donating $50 million for monitoring and surveillance in South Africa.

The Lilly program builds on a $70 million investment in 2003 when the company allowed companies in South Africa, China, Russia and India to manufacture generic drugs.

But XDT is not the only problem. Slightly less dangerous is the MDR-TB (multi-drug resistant) strain, which flourishes in African shantytowns where many live in dark, crowded huts, as well as elsewhere in the world.

MDR-TB does not respond to the two most powerful TB drugs available, so patients are forced to take up to 30 tablets a day. The extra medicines can cause side effects, such as vomiting, diarrhea and severe depression.

(Additional reporting by Laura McInnis in Geneva, Jeremy Clarke in Nairobi and Sarah McGregor in Johannesburg)

China to launch national survey on tuberculosis drug-resistance

China's Health Ministry is to launch a two-year national survey on patient resistance to drugs to treat tuberculosis.

The survey, scheduled to start in April, will be conducted at 70 research bases covering all of China's provinces, ethnic minority regions, and four municipalities, a ministry official said.

"The situation of tuberculosis drug-resistance in China is thought to be very serious. The international organizations estimate Chinese account for 25 to 33 percent of the world's total infections," said Xiao Donglou, deputy director of the ministry's Center For Disease Control and Prevention (CCDCP).

Xiao said the ministry would establish a monitoring system for drug-resistance as the survey progressed.

The survey is expected to cost more than 17 million yuan (2.15 million US dollars), including the purchase of facilities, he said.

A similar survey in 2000 based on a much smaller research pool showed 27.8 percent of patients were resistant to one drug and 10.7 percent to more than one.

"The high rate of drug-resistance leads to a high death rate and the issue has become a priority in the country's disease prevention efforts," said Zhao Yanlin, a CCDCP researcher.

Chinese Scientists to study biological and genetic aspects of HIV/AIDS

China launched a five-year research project Wednesday aimed at answering a number of HIV/AIDS-related puzzles such as why Chinese people are genetically predisposed to be more easily infected with the virus.

Led by Dr. Zhang Linqi, director of AIDS Research Center of Chinese Academy of Medical Sciences, the state-funded project will focus on eight research areas including how the HIV virus mutates and remains latent in the human body and why Chinese seem to be more easily infected with the virus through sexual contact.

According to the project, China will also bring together AIDS specialists from across the country to form its first team dedicated to systematic clinical research on the deadly disease.

China reported 183,733 HIV/AIDS cases in 2006, up 30 percent from 2005. Experts from the Ministry of Health estimate there are actually 650,000 people living with HIV/AIDS in China.

Behavioral intervention reduces risk of HIV spread

Wed Mar 21, 2007 7:51 PM ET

NEW YORK (Reuters Health) - People living with HIV infection who participate in a psychotherapy program can significantly reduce their risk of transmitting the virus, the results of the Healthy Living Project show.

The program consists of "cognitive-behavioral" therapy, a type of counseling that focuses on the key role that thinking plays in feelings and behaviors. Proponents of this therapy believe that unwanted feelings and behaviors can be changed by alteration of the thinking patterns that lead to them.

Dr. Stephen F. Morin of the University of California, San Francisco and colleagues assigned 936 individuals with HIV infection, and at risk of transmitting the virus, to the cognitive-behavioral therapy or to no intervention.

The program consisted of fifteen 90-minute sessions, covering three modules. One module consisted of stress, coping and adjustment behaviors; the second involved teaching safer behaviors; and the third was a program of healthy behaviors.

Follow-up assessments were conducted at 5, 10, 15, 20 and 25 months. The goal was to see if the behavior intervention reduced a person's HIV transmission risk, defined as "the number of unprotected sexual risk acts with persons of HIV-negative or unknown status," the team reports in the Journal of Acquired Immune Deficiency Syndromes.

HIV transmission risk was reduced by 36 percent in the intervention group compared with the no-intervention group, at the 20-month assessment.

"Unfortunately, the treatment effect in terms of a reduction of HIV transmission risk acts was not maintained at 25 months," the investigators report.

Morin and colleagues point out that "even small behavior changes among infected individuals can have a significant effect on the epidemic." This suggests that the behavioral intervention used in this study "can be effective in reducing the number of new HIV events."

Gilead CEO Martin Receives $13.7 Million

NEW YORK (AP) -- Gilead Sciences Inc. President and Chief Executive John C. Martin received about $13.6 million in compensation last year, the biotech drugmaker said Friday in a proxy filing.

Martin received a $998,000 salary, nearly $1.5 million in non-equity incentive plan compensation and stock and option awards valued by the company at $11.2 million, according to a filing with the Securities and Exchange Commission.

The CEO also received about $3,670 listed under "All Other Compensation," a category often used to account for perquisites like club memberships and travel expenses.

The Associated Press' calculations of total pay include executives' salary, bonus, incentives, perks, above-market returns on deferred compensation and the estimated value of stock options and awards granted during the year. The calculations do not include changes in the present value of pension benefits.

Shares of Foster City, Calif.-based Gilead, which makes HIV drugs Truvada, Viread and Emtriva as well as partnering with Bristol-Myers Squibb on the combination HIV drug Atripla, closed at $74.73 Thursday on the Nasdaq Stock Market.

TCM expected to play important role in rural China

BEIJING, March 12 (Xinhua) -- Chinese political advisors attending their annual full session in Beijing said that traditional Chinese medicine (TCM) should play an important role in health care in rural areas.

"Chinese have relied on TCM for thousands of years while Western medicine was introduced into the country several hundred years ago. TCM should and can play a bigger role in rural areas," said Zhu Qingsheng, former vice minister of health and now a member of the National Committee of the Chinese People's Political Consultative Conference (CPPCC), the top advisory body.

Zhu's remarks won consent of a number of CPPCC members both from the medical sector and other circles. "I believe TCM is a good tool in building a system of primary health care services for both urban and rural residents," said CPPCC member Ha Xiaoxian, who is also an expert from the Harbin Traditional Chinese Medicine Research Center.

TCM was widely used in the rural health system after the founding of the People's Republic of China in 1949, and helped double the country's average life expectancy from 35 years in 1949to 68 years in 1978. However, it is losing out to Western medicine in the popularity stakes in China, according to an online survey last year.

A nationwide debate erupted over the survival of TCM last year after an online proposal by Zhang Gongyao, a professor with Central South University, urged China's health authorities to remove TCM practices from national health service. It attracted both support and outrage from thousands of netizens.

Supporters of the proposal labeled TCM as "unscientific and untrustworthy" and opponents lambasted supporters for ignoring history and the true values of TCM.

China's Ministry of Health has made its opposition to the proposal, saying "TCM is an inseparable and important component of China's health sector" and "Chinese medicine has been acknowledged in a growing number of foreign countries."

In the government work report delivered on March 5 at the opening of the National People's Congress (NPC), Chinese Premier Wen Jiabao said the government would strongly support the development of traditional Chinese medicine and the folk medicine of ethnic minorities and give full play to their important role in preventing and treating illnesses.

However, China is in dire need of experienced TCM doctors as there are only 270,000 practitioners in the country and only 30,000 of them practice TCM only, most of whom are above 50 years of age, according to CPPCC member Si Fuchun, an expert from Henan College of Traditional Chinese Medicine.