Health Policy and TB

Health policies makers have only worsened the affect of multi-drug resistant (MDR) Tuberculosis because they are ignoring the severe infectious disease. Health policy administrators are trying to help the less problematic disease.

The issue with health policies date back to about ten years ago when there were less cases of MDR Tuberculosis. At this point, Indonesia and India were the countries that had the most outbreaks of this disease. When the topic of using reserved second line drugs was brought up, policy makers deemed these countries too poor. The second line drugs were expensive and limited in availability. The popular belief among policy makers was treating MDR tuberculosis would down play the attention and resources from treating other curable diseases.

Currently, policy makers worry for patients who do not have MDR tuberculosis because many countries would start to focus only on the drug resistant form of tuberculosis. Some parts of the world would go without using direct observed treatment or use their scare resources on MDR tuberculosis.

Would policies for MDR tuberculosis take away resources from regular tuberculosis?

The lack of data about this public health issue is another contributing factor. Now, we are aware about this disease presence. Since there is nothing occurring to better the situation it is as if we didn’t know about it at all. Policy makers need to build an international consensus to understand how badly this disease is affectingWHO TB Efforts the world and where to focus its attention. Helping the worse affected countries first will reduce the work load as the eradication process begins.

Policy makers need to help create or fund a new mechanism to promote the treatment of MDR tuberculosis. This mechanism needs to be able to reach millions of people so an illustration would be better suited. Models of care and strategies should be created to inform developing countries about this disease. Overall, there needs to be an increased capacity of drug sensitivity testing and reduce the delays in treatment. Community based treatment models need to be enacted by policy makers and promoted by government officials. These treatments need to provide a full course of treatment and provide food, transportation and economic assistance.

Policy makers need to revise the international guidelines for the treatment of MDR tuberculosis using new models and strategies. Along with revisions, new treatment and funding initiatives should be made for the future.

Health policy administrators have the possibility and power to truly change the lives of the infected patients. It is troubling as a hopeful health administrator to see how they are completely blind-siding this issue. I hope that this disease will not have to kill or ruin the lives of many other individuals just to get noticed by policy makers.

Sadly, in the case of this drug resistant tuberculosis we see how history is repeating itself. Policy makers have yet to improve the situation of MDR tuberculosis.

Here is a link to an article from 2012 where the World Health Organization issues a new policy to step TB efforts!WHO TB Efforts

References

Global alliance for TB drug development; TB partnership names director of policy. (2005). Lab Law Weekly, , 99. Retrieved from http://search.proquest.com/docview/225046654?accountid=14541 

Andrew Carle

The health administration field is filled with powerful individuals who want to succeed for the glory or money. I have personally met one scholar at George Mason University who doesn’t wake up every day for a selfish reason; he wakes up ready to better the lives of senior citizens and their family members. Today, I would like to introduce everyone to an important professor that is a part of the George Mason University faculty. His name is Andrew Carle. I just recently took one of his classes in the spring semester and saw his scholarly qualities shine through his lectures.

Mr. Carle studied at the State University of New York at Buffalo. He studied business administration and successfully graduated after four years. After taking a one-year break from school, he decided to attend the George Washington University school of Medicine and Health Sciences. At this school, Mr. Carle was able to get his Masters in Health Administration. He started his own consulting company that helps other businesses improve their assisted living facilities. He is also currently a consultant advisor at the GTX Corporation for his new business venture. He has more than 25 years of executive healthcare and senior housing working experience.

Mr. Carle has been working at George Mason University for thirteen years. He teaches undergraduate and master courses about health administration. He is the founding director of the senior housing program at GMU. This program is the only program available in the whole country. In 2012, he received an award called “Master Teacher” Award from the GMU College of Health and Human Services for his excellent teaching skill.

His newest business idea, “Nana” Technology has been featured in Forbes magazine, CBS news, the Washington Post and Chicago Tribune. “Nana” Technology is a GPS tracking system that is inside a shoe. The booming senior population has made most of us aware of the dangers of Alzheimer’s. This new technology is going help senior citizens who have a tendency to wander. Now their family members or caretakers won't have to panic because they will be able to track the senior citizens exact location. This product is putting our technological advancements to good use!

University based retirement communities is another achievement made possible by Mr. Carle . More and more retired individuals are heading back to school. His idea is for retirement communities to build a formal relationship with a neighboring  university so that seniors can get benefits. Building retirement facilities closer to universities will provide a stimulating environment for both generations. His five criteria for  university based retirement communities include tailored programming, proximity, and senior housing services, alumni base and financial planning.

 I chose to write about this professor at Mason because he really inspired me. He came to one of my general education classes as a guest speaker during my freshmen year. I was having trouble with my nursing perquisites and was unsure what other major to declare. When he came to my class, he seemed so driven and ready speak to my whole lecture class about this program at Mason. He spoke with so much compassion, it seemed like he wasn’t just good at his job but he really enjoyed. That is the American dream!

Have you seen this man around campus?

Here is an external link to his consulting website Carle Consulting

Current Event

I found an article “Return of the ‘White Plague’: Fears over the rise of ‘incurable’ TB” on the CNN website. It is a great follow up article to my last post because it also talks about the relevance and significance of this disease.

 The article starts with a compelling story about a man named Adile from South Africa. He previously contracted tuberculosis and did not receive proper treatment in his hometown, Cape Town. Now, he is infected with extensively drug resistant (XDR) tuberculosis and has no hope that he will get better. He explains how his current environment is not clean and it increases the risk of contracting tuberculosis.

 In South Africa, tuberculosis is the leading cause of death. This country is suffering through a public health emergency because of the increasing number of people developing XDR tuberculosis. About half a million cases are reported and now a large percentage of cases are drug resistant tuberculosis. Poor nutrition, ventilation, housing are examples of how drug resistant tuberculosis is mainly being transmitted through person-to-person contact.

The Cause of XDR Tuberculosis

            When the disease is not properly treated, the bacterium has a chance to mutate and become drug resistant. Many individuals from Africa do not finish their full course of treatment and run the risk of developing XDR. Since they are not treatable with the common drugs for tuberculosis, patients will have to take stronger medication. Some of the medication might have extreme side effects and could potentially cause more harm to the immune system. If individuals do not seek treatment right away then it could cause permanent damage to the lungs and cause eventual death.

Global Burden

On a global scale, XDR- tuberculosis has the highest reported cases in Russia, Eastern Europe, China and India. At least one case of this type of tuberculosis has been reported in ninety-two countries. It is likely that more cases are out there but remain unreported. In India and China, there are patients who are incurable because they have developed a vast resistance to drugs. The countries with the most cases of XDR tuberculosis need the most help because if they don’t improve then there is no hope for the rest of the other countries.

The World Health Assembly agreed to improve the long-term tuberculosis strategy. They believe if this drug resistant form of tuberculosis continues to spread it could be the number one infectious disease. Their main goal is to reduce tuberculosis deaths by ninety-five percent between 2015 and 2035. The assembly fears that other diseases will also become drug resistant.

The World Health Organization plans to aid the most affected countries first to improve their diagnosis and treatment of drug resistance. The most important task will be making sure the patients continue taking alternative drugs for at least two years. If they do not continue with treatment it can just spark more drug resistant forms to develop. The organization also plans to control the transmission of this disease.

This article serves as a great tool to demonstrate how serious this disease is and to publicly inform the population.  Do you think there are other ways to handle this disease? Is shutting down borders a productive or counterproductive measure for this disease?
Summarized Article  This is an external link to the article I summarized for my post! 
References
Senthilingam, M., & story was partly supported by the Pulitzer Center on crisis reporting. (2014, May 28). Return of the 'White Plague': Fears over the rise of 'incurable' TB. CNN. Retrieved , from http://www.cnn.com/2014/05/28/health/return-white-plague-incurable-tb/
XDR-TB. (n.d.). WHO. Retrieved from http://www.who.int/tb/challenges/mdr/xdr/en/
 

Eradication of TB?

Introduction

Tuberculosis (TB) is a life threatening disease that has historically affected millions of people.  It is a contagious bacterial infection that usually occurs in the lungs.  Some risk factors of this disease include individuals who have comprised immune system, alcoholics or drug users, and HIV infected patients. This disease requires patients to take several medicines for treatment. TB is an airborne disease that is very easily transmitted especially in closed environments. Medical workers are at a heightened risk of infection.

TB has recently mutated into a superbug! Alas, these new forms of TB are called Multi-drug resistant (MD) TB and Extensively drug resistant (XDR) TB. These bugs are resistant to the main drugs used to treat patients of TB. XDR is a rare form of drug resistant TB and extremely difficult to treat. These resistant types of TB have formed because the patients taking their TB medications have misused or mismanaged the drugs. Patients mistakenly take the wrong required dosage amount or use drugs that are poor quality.

This disease does not just affect the immune system of an individual, it takes over their whole life. TB patients are not able to go to work normally because they have an infectious disease. If they are not able to go to work then their insurance will be terminated and they will have no way to pay for their several medications for treatment.  This disease could severely impact the socio-economic position of a developing country. Individuals will also be unavailable to their loved ones while going through this disease. It is seriously damaging to the quality of life.

The threat of TB is growing and continuing. TB is the second leading cause of death in the world, after HIV. About 1.3 million people died just last year. Reportedly, 10,00 deaths occurred in the United States. It is evident that this powerful infectious disease needs to be eradicated but the concern is how can it occur. In addition, XDR and MDR are more obstacles toward the eradication path.

Now the question is, how do we eradicate TB when new and stronger forms are developing?

There needs to be a global force that is educating and informing the world about TB. We need to take advantages of countries resources to make this a healthier and better world for all of us. Political leaders need to get involved because they can form special committees that are in charge of campaigns for eradication. They can also increase funding for this particular disease.

Thanks to science and research developments, alternative treatments are also being developed to treat TB. Therapeutic drug monitoring could be a solution to this disease. It’s main focus is on individually adjusting the dose of drugs.

The “Stop TB Strategy” created by the World Health Organization is trying to reduce the global burden of Tuberculosis. By 2015, they are planning to protect the vulnerable populations from TB, support development of effective tools, and reduce the socioeconomic burden of TB (“The Stop TB”, 2014). Their goal for 2050 is to eliminate TB as a public health problem. The TB strategy incorporates 6 components, which will help them to achieve their goals for 2015 and 2050.

   After hearing all this information, do you think it is possible to eradicate TB?
Stop TB Partnership This is link to the Stop TB partnership website where you can learn more about plans for the future eradicate TB

References        

  The Stop TB Strategy . (n.d.). . Retrieved June 16, 2014, from http://www.who.int/tb/publications/2010/strategy_en.pdf?ua=1

Tuberculosis eradication program focuses on high-risk patients. (2003). Annals of Internal Medicine, 138(4), 321. Retrieved from http://search.proquest.com/docview/222190497?accountid=14541

Tuberculosis (TB). (2014, January 1). WHO. Retrieved June 11, 2014, from http://www.who.int/topics/tuberculosis/en/