Saturday , April 17 2021

North Korea is growing in tuberculosis medications, experts fear the epidemic

Eugene Bell Foundation President Stephen Linton talks during a press conference in Seoul, South Korea, Friday, November 16, 2018. The US-based non-profit group has called for South Korea to take stronger measures to fight the tuberculosis crisis in North Korea. It worsened under the sanctions reinforced by EE. UU. about its program of nuclear weapons and missiles. (AP Photo / Lee Jin-man)

Seoul, South Korea (AP): The withdrawal of an important international aid organization threatens to leave tens of thousands of patients with tuberculosis in North Korea without the medication they need and can go into a serious crisis if it is not treated promptly, according to health experts familiar with the situation in the north.

The cumulative stock of crucial medicines continues the abrupt march of the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international aid organization whose subsidies to North Korea supported the treatment of 120,000 tuberculosis patients last year. Its support officially ended in June despite a clamor among the health officials in North Korea and in the international community that could cause an important epidemic.

Neurosurgeon Kee Park, from the Global Surgery and Social Change Program at Harvard Medical School, said in an email to The Associated Press that the situation is very serious and will probably worsen dramatically in the coming years if it is not treated correctly.

The US-based, non-profit, Eugene Bell foundation, working in the field treating tuberculosis in North Korea, said yesterday that the crisis is being exacerbated by US-led sanctions by the Pyongyang missile and nuclear weapons program .

North Korea has one of the highest tuberculosis rates in the world, a highly infectious disease that, although it is treatable, annually causes more than 1 million deaths. According to the World Health Organization, about 107,000 cases of tuberculosis were reported in North Korea in 2017. In fact, North Korea estimated that 6-7 percent of its tuberculosis population has the drug-resistant, well-known variety Like MDR-TB, which is much harder and more expensive to cure.

"As a result of the loss of subsidies from the Global Fund for the DPRK, we expect a 50-75 percent reduction in treatment capacity for patients with non-MDR TB," said Park. "Accordingly, our model predicts between 155,000 and 210,000 more people will die for TB-related causes within five years. To be clear, these are new deaths that are expected at the top of the current mortality rates. We assume that the treatment of MDR-TB will continue at current levels. "

Drug-resistant tuberculosis usually results from patients who do not take the right amount or combination of medications to completely cure the disease, or by contacting someone who has already been infected.

It is frequently found among populations that had some exposure to tuberculosis medications, such as cities or other places with relatively richer populations or, at least, rich enough to pay for some type of TB medication.

Pyongyang, the North Korean capital, is believed to have a particularly high incidence of TB-resistant drug strain.

The Global Fund announced in February that it was finalizing its subsidies to North Korea and that it effectively ended the largest external health care program for the North due to a lack of transparency and difficult operating conditions. He said his stock would last one year, which exceeds the average 6 to 9 months of treatment for a patient with TB.

But the concern is what will happen next, how can new cases be treated if no one enters to fill the gap and if the drug limited group would be "rationed" in an unobserved effort to spread the remaining medications.

"Time is ticking," said Park. "I've heard of people who were inside recently that rationing has already started."

The problem is especially acute because North Korea has a fragile public health system that could easily be overwhelmed by a large outbreak, sending Koreans across the country's border with China, causing the epidemic to be a larger regional problem.

Concerns about such calamity have caused the North to close borders essentially during the scare of Ebola in 2015 and during the 2003 SARS outbreak in China, although neither seemed to be a threat to the northern isolate.

Stephen Linton, President of the Eugene Bell Foundation, told reporters in Seoul that South Korea lacks an urgent need to help groups like their waivers of gain sanctions so they can deliver supplies to treat patients in North Korea.

He compared the problem that the house is on fire and said that the North Korean tuberculosis problem could have health consequences for South Korea.

Linton said he believed that the decision of the Global Fund was at least partially linked to pressure related to sanctions. The United States government, which has promised $ 1.4 million this year, is one of the largest donors of the Global Fund.

He noted that it has also become more difficult for US aid workers to obtain permission to travel to the North since President Donald Trump announced his ban on traveling to US citizens for more than a year.

Choi Seemoon, a director of Eugene Bell, said that while Eugene Bell and Global Fund provided MDR-TB medications to about 2,000 patients this year, less than 30 percent of the estimated 8,000 Koreans with this condition. The regular tuberculosis stock of the Global Fund will end in early 2020, he warned, while the stock of MDR-TB can only cover patients registered in the autumn of this year.

"There must be a rapid purchase of medication and materials to overcome the gap left by the Global Fund," said Choi. "If the problem is resolved through inter-Korean conversations or through international agencies and non-governmental channels, there must be a rapid delivery of tuberculosis medicine to North Korea regardless of the channel I take."


Talmadge is the head of Pyongyang capital of AP. Contributed to this Tokyo report. Follow him on Twitter and Instagram: @EricTalmadge.

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