The central government may be considering a large increase in funding to fight tuberculosis (TB).

Ministry of Health officials said several hundred million yuan will be used to provide TB patients with DOTS (directly observed treatment, short course) therapy. DOTS is a universally applied treatment recommended by the World Health Organization (WHO).

The funds will also be used to reward medical workers who find new patients and ensure patients take medicines regularly, officials said.

Presently, the central government allocates some 40 million yuan (US$4.8 million) each year mainly for medical treatment.

It is one of the central government's major programmes to meet global targets for TB. China has committed to meet the targets, which call for at least 70 per cent of new smear-positive (infectious) TB cases to be detected timely by 2005. At the same time, all patients must be provided with DOTS treatment and a cure rate of 85 per cent must be achieved, said Wang Wenjie, division chief in charge of TB with the Disease Control Department of the Ministry of Health.

Wang Longde, vice-minister of health, made the commitment during the Second Stop TB Partners' Forum held in March in New Delhi, India.

Presently, the case detection rate of TB patients in China stands at about 45 per cent, while DOTS coverage is approaching 100 per cent and the cure rate is over 85 per cent, said Wang.

Tuberculosis is the leading infectious cause of death in China. The country ranks second in the world in terms of the number of TB patient. India is first.

WHO has listed China as one of 22 countries with a high TB-burden.

Of China's 4.5 million people suffering from TB, 1.5 million are infectious. The country sees 1.45 million new cases every year and 130,000 deaths.

To achieve the TB control goals, the Ministry of Health, with assistance from experts from WHO and other international agencies, have sent out several supervision teams to several provinces and municipalities, said Wang Wenjie.

A notice has been issued by the Ministry of Health, asking local health institutions, especially those at county and township levels to tighten monitoring, reporting and management.

The ministry is also considering using mobile medical vans to provide basic medical care services for people in remote and rural areas to find more new patients and treat them in time.

The TB project in China has received extensive support from the international community.

The World Health Organization, World Bank, the Department for International Development (DFID) of the UK, Damien Foundation, the Government of Japan, Global Fund to Fight AIDS, Tuberculosis and Malaria and other national and international non-governmental organizations played important role in the projects.

One on-going project with the World Bank/DFID, UK, a loan of US$104 million has been committed to China over seven years from March, 2002 to treat TB patients in China.

An estimated 680 million people in 16 provinces and autonomous regions will benefit and more than 2 million patients are expected to get access to free medical treatment.

The World Bank has helped China since 1990 expand effective TB control services to many of its largest cities and the majority of its provinces.

The TB Control programme under the World Bank-financed Infectious and Endemic Disease Control Project has been cited by the WHO as one of the most successful TB control interventions in the world, with patient cure rates surpassing 90 per cent.

The World Bank recently granted an Award of Excellence to the China TB Control Programme Team.

Just last week, former South African President Nelson Mandela called on the world to pay more attention to TB. He said the fight against aid should not overshadows the pressing need to deal with TB in developing countries.

(People's Daily  July 23, 2004)