The world health community is struggling to contain the SARS outbreak. While people may have fears about this new menace, the centuries-old disease tuberculosis still poses a serious threat to world health.
The World Health Organisation (WHO) is spearheading the global effort to eradicate the disease. Twenty-two countries account for 80 per cent of the world's cases. To give an idea of the scale of the problem, more people die from TB than from any other curable infectious disease in the world. Paradoxically TB can be effectively treated with a course of special antibiotics taken for at least six months. Hence the World Health Assembly have set the target of eliminating TB as a public health problem by 2050.
Those of us who live in the developed world and have access to modern medicine and decent sanitation are less at risk of tuberculosis, but as the experience of my parliamentary colleague Ian McCartney MP, the Labour Party Chair, demonstrates, tuberculosis is not confined to the developing world.
In December last year, the WHO and the Stop TB Partnership held a briefing about the world TB epidemic for MPs at the House of Commons. At the briefing, Ian revealed he had contracted TB in 1992. When Ian began to feel unwell, his doctors initially thought his illness could be attributed to stress. According to Ian, it took him nine months to convince his doctors that his illness was not stress-related but something more severe. Ian underwent a course of treatment for TB, but he had to seek further help for the painful after-effects caused by scar tissue - and will now be on medication for life.
As a London MP, I have been particularly interested in what is being done to combat the disease in the Capital. TB is on the rise in Britain: in 1987, there were 5,500 reported cases of tuberculosis. Last year there were 7,300 cases of TB, of which 3,000 cases were in London.
The suggestion that immigrants are importing the disease into Britain is little more than xenophobia. TB tests on about 5,000 asylum seekers screened under a pilot Home Office scheme failed to find one potential refugee with an infectious disease.
The rate of TB in London is now at developing world proportions. The rate of TB in London is 40 per 100,000 - compared with Yugoslavia, which has an incidence rate of 39 per 100,000.
These statistics are worrying, but the rise in TB rates offers no clearer illustration of why public and preventative health must be higher up the government's agenda. TB is a nasty disease making a frightening comeback, but in order to avoid a SARS-like panic, doctors and the public need to be properly informed about the symptoms of TB. As Ian's case shows, doctors often make an incorrect initial diagnosis. Indeed there have been cases of TB misdiagnosed as asthma. The most important part of controlling TB is identifying and treating those who already have the disease, in order to shorten their infection and to stop it being passed on to other people.
The Health Protection Agency is correct to point out that, "although anyone can catch TB, for most people in the UK the risk of contracting the disease is very small indeed". Moreover the warnings about TB must not cause a rush to repressive measures against patients with TB, or populations where TB is common. But how do you halt the rise of TB cases in Britain?
For a start, the government's plans for combating the disease must include solutions to the affordable housing crisis. According to medical experts, many TB cases might be explained by poor housing, poor diet and inadequate access to health services. Hostels are not a long-term solution to homelessness. We have a very significant crisis in affordable housing and it is not just the homeless, the overcrowded, the poorly housed or the poorly paid who are losing out. The government must realise that there is a link between the London TB crisis and the affordable housing crisis.
The suggestion that immigrants are importing the disease into Britain is little more than xenophobia. TB tests on about 5,000 asylum seekers screened under a pilot Home Office scheme in Kent last year failed to find one potential refugee with an infectious disease. Hence calls for compulsory screening of immigrants are misplaced. They are already offered screening. The difficulty is ensuring that potential cases are identified and followed up - especially as TB can lie dormant for periods.
It was 10 years ago that the WHO declared TB a "global health Emergency". The health community have redoubled their efforts to eliminate this nasty - but treatable - disease. The health authorities have certainly heeded the dire warning of a "national public health disaster waiting to happen in the UK". The rise in TB rates reinforces the need for more decent and affordable housing, especially in London. There is also an urgent need to raise public awareness in order to prevent, control and ultimately eradicate this disease.