‘Brunei has made great strides in controlling TB’

National 4 minutes, 11 seconds

WORLD Tuberculosis (TB) Day is one of eight official global public health campaigns marked by the World Health Organization (WHO) and is commemorated each year on March 24.

It recalls the discovery of the TB bacillus, thus allowing for its prevention, diagnosis and treatment. It is a day to build public awareness about the global epidemic of TB and our efforts to eliminate the disease. Significant advancements have been made in TB care, including BCG vaccination. However, even today, after the development of advanced screening, diagnostic and treatment methods for the disease, a third of the world’s population has been exposed and is currently infected with TB.

Despite being both preventable and curable, the disease remains a major global health problem, responsible for illness among 9 million new cases each year and the deaths of 1.5 million individuals. Worldwide, TB ranks as the second leading cause of death from an in fectious disease after the human immunodeficiency virus (HIV). Of the 9 million people newly diagnosed with TB each year, a third of them are “missed” by the health systems. Many of these 3 million people are among marginalised populations such as migrant workers, prisoners and drug users.

In Brunei Darussalam, progress towards TB control has been remarkable. As a country, we have achieved the United Nations Millennium Development Goal (MDG) 2015 target to reduce by 50 per cent the burden of TB. The incidence rate (new cases) has decreased from 91.9 per 100,000 population in the year 2000 to 48.7 per 100,000 population in 2014. Despite this improvement, the rate of decline has become stagnant in recent years.

An ageing population, increase in the number of people with chronic diseases (particularly diabetes mellitus) and smoking contribute to the ongoing TB incidence in Brunei. As such, TB remains a public health priority for Brunei Darussalam with approximately 200 new cases occurring every year. Persistent cough, fatigue, fever, night sweats and weight loss are common signs and symptoms of TB, and persons experiencing these symptoms should consult their doctor.

This year’s theme, “Unite to End TB”, is particularly pertinent for us in Brunei Darussalam and is especially well-aligned with the Ministry of Health’s strategic priorities for the next five years: to make health everyone’s business, to enhance quality of service delivery and to prevent and control non-communicable diseases.

In the coming year, in addition to continuing to provide high quality care to those diagnosed with TB, the Ministry of Health will focus on ensuring the case detection and diagnosis of those individuals still not reached, along with additional efforts to find and treat latent TB infection which holds the key to stopping the cycle of TB transmission.

To this end, the Ministry of Health has adopted the recommendations of the WHO post-2015 global TB strategy – the End TB Strategy. The overall goal of the strategy is to end the global TB epidemic, with corresponding 2035 targets of a 95 per cent reduction in TB deaths and a 90 per cent reduction in TB incidence (both compared with 2015), and 2050 target of TB elimination as a public health problem. To achieve this in Brunei Darussalam, the Ministry of Health Plan of Action for the Control of TB focuses on:• Increasing the awareness of all, including health professionals and the public regarding TB;• Enhancing the TB screening program;• Continuing to ensure appropriate treatment and monitoring of TB patients, including preventing the emergence of drug-resistant TB.

Disease surveillance in the country indicates that certain high-risk groups are vulnerable to TB. These include those individuals in prison and detention centres and also individuals with diabetes due to their lowered immune response. Consequently, the prevention and control of non-communicable diseases, especially diabetes, are of particular importance in the fight against TB in Brunei Darussalam. A successful TB elimination strategy cannot solely be based on treating the acute infection, but it must be an integrated approach that takes into account both environmental determinants as well as other chronic diseases that increase the risk of acquiring TB.

To further strengthen the effectiveness of our TB prevention and control measures, it is vital for the Ministry of Health to reach out and work together alongside our clients - the local community. Dialogue and partnership engagement with relevant stakeholders underpin our approach to tackling the burden of TB in Brunei. We all have a role to play in our families and our communities to identify those individuals at risk of infection, ensure that they seek medical attention, and assist them in complying with medical care.

World TB Day provides the opportunity to raise awareness about TB-related problems and solutions and to support our national TB-control efforts. While great strides have been made to control TB in Brunei Darussalam, people still get sick and die from this disease. As a society, we can do more to eliminate this disease and prevent future deaths. TB is preventable, and working together in partnership, we will achieve our vision of a healthy nation.

Message by Health Minister Yang Berhormat Dato Paduka Dr Hj Zulkarnain Hj Hanafi in conjunction with World TB Day 2016

The Brunei Times