Monday , September 26 2022

North Korea: Experts fear the epidemic of tuberculosis



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(SEOUL) – The withdrawal of a major international aid organization threatens to leave tens of thousands of North Korean tuberculosis patients without the drugs they need and can spiral into a serious crisis if they do not return soon, according to health professionals who are familiar with the situation in the north .

Reduction of key stocks is accompanied by the sudden departure of the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international aid organization whose grants for North Korea last year supported the treatment of 120,000 TB patients. His support officially ended in June despite a protest among health officials in North Korea and the international community that could trigger a major epidemic.

Neurosurgeon Kee Park from a program in global surgery and social change at Harvard Medical School, in The Associated Press, says the situation is extremely harsh and is likely to dramatically worsen in the coming years if this is not resolved appropriately.

The US non-profit foundation, Eugene Bell, who works on tertiary therapy in North Korea, said on Friday that the crisis is further compounded by US-led sanctions over nuclear weapons and the missile program of Pyongyang.

North Korea has one of the highest rates of tuberculosis in the world, a highly contagious disease that, although it can be treated, globally causes more than a million deaths each year. According to the World Health Organization, about 107,000 cases of tuberculosis have been reported in North Korea in 2017. What's worse, North Korea estimates that 6-7% of the tuberculosis population has a drug-resistant strain, known as MDR-TB, which is much more difficult and costly to cure.

"As a result of the loss of Global Fund grants to the DPRK, we expect a 50-75% reduction in the capacity to treat non-MDR-TB patients," Park said. "For this reason, our model predicts that between 155,000 and 210,000 more people die from tuberculosis-causing agents within five years.To be clear, these are the new deaths that are expected above the current mortality rates." We have assumed that the treatment of MDR- TB continue at the current levels. "

Drug-resistant tuberculosis is mainly the result of patients who do not take the appropriate amount or combination of drugs to completely cure them or contact someone who has already been infected.

It is often found among populations who have been exposed to TB drugs, such as cities or other sites with populations that are relatively rich – or at least rich enough to already pay some form of TB drugs.

It is believed that Pyongyang, the capital city of North Korea, is particularly high in drug-resistant tissue.

The Global Fund announced in February that it had completed its donations to North Korea, effectively ending the largest external public health aid ever for the North, due to the lack of transparency and harsh working conditions. She says her stock will last a year, which is longer than the average 6- to 9-month treatment for a TB patient.

But concerns about what will happen afterwards, how can they deal with new cases, if no one else is advancing to fill the void and whether a limited pool of drugs will be "rational" in an unconditional effort to expand what medicines have remained .

"Time goes," Park said. "I heard from people who were recently in the house that the comparison had already begun."

The problem is particularly acute because North Korea has a fragile public health system that could be overwhelmed by a major epidemic, sending North Korean countries across the border with China, making the epidemic a major regional problem.

Concerns about such an accident have led Severus to essentially close its borders during the Ebola offense in 2015. year and during the outbreak of SARS in 2003 in China, although none of them seem to have presented a big surge to the isolated north.

Stephen Linton, chair of the Eugene Bell Foundation, told reporters in Seoul that South Korea lacked the need to help groups such as his release from sanctions, so they could provide supplies for the treatment of patients in North Korea.

He compared the problem of burning the house next to the house and said North Korea's problem with tuberculosis could have health consequences for South Korea.

Linton said he believed that the Global Fund's decision was at least partially related to sanctions-related pressures. The US government, which promised $ 1.4 billion this year, is one of the largest donors to the Global Fund.

He noted that US humanitarian workers were harder to get permission to travel to the north, as President Donald Trump announced a ban on travel for US citizens more than a year ago.

Choi Seemoon, director of Eugene Bell, said that while Eugene Bell and the Global Fund donated MDR-TB drugs to around 2,000 patients this year, this is less than 30% of the estimated 8,000 North Koreans with these conditions. The stock of the regular tuberculosis drug of the Deep Fund will be exhausted at the beginning of 2020, she warned, while her MDR-TB drug fund was only for patients registered until the autumn of this year.

"It is necessary to quickly obtain medicine and means to overcome the gaps left by the Global Fund," said Choi. "Whether the issue is resolved through intercourric talks or through international bodies and non-governmental channels, there should be a rapid delivery of tuberculosis drugs in North Korea, regardless of which channel is needed."

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