Health officials to attend International Summit on Tuberculosis and Diabetes in Bali, Indonesia

Bali summit marks first major effort to mount defense against looming co-epidemic

Health officials from the governments of Indonesia and India will join advocates, civil society groups, researchers and businesses from Asia, Europe, Latin America and North America in Bali, Indonesia on 2-3 November at the world’s first International Summit on Tuberculosis (TB) and Diabetes in an effort to avert a global health crisis.

Diabetes weakens the immune system, and triples a person’s risk of getting sick with TB. Today, 387 million people are affected by diabetes, with 77 per cent of cases in low- and middle-income countries where TB is prevalent. Diabetes is projected to affect 592 million people by 2035—and thereby raises the spectre of a devastating increase in TB.

Recent studies have shown between 16 and 46 per cent of people living with TB also have diabetes, and many are unaware of it. With an estimated nine million cases of TB each year, the convergence of the two diseases threatens to become a major public health crisis.

“Rarely in public health do we see two diseases of such magnitude coming together like we’re now seeing in the case of TB and diabetes,” said Dr Anthony D Harries, Senior Advisor and Director of the Department of Research for the International Union Against Tuberculosis and Lung Disease (The Union). “This summit provides an opportunity to bring leaders together now to make commitments and chart a public health response. We see it as a catalyst for global action.”

The summit in Bali marks the first major effort by international health officials and advocates to mount a concerted defense against the looming TB-diabetes co-epidemic. Attendees will review the latest scientific and clinical information on the state of the two diseases. They will also be asked to sign The Bali Declaration, which will commit them to taking cost-effective actions, such as the implementation of bidirectional screening: automatic TB testing for people living with diabetes, and vice-versa.

“With TB-diabetes, we’re seeing an infectious disease and a non-communicable disease interacting in the same patients and compounding the effects of each individual disease,” said Dr Anders Dejgaard, Managing Director of the World Diabetes Foundation. “This challenges the conventional approach to medicine and public health. That’s why we’re bringing leaders and experts in infectious disease together with their counterparts in non-communicable diseases, and we’re convening leaders in government, industry and civil society so we can identify concrete solutions that countries can begin implementing immediately.”

The Ministry of Health of the Government of Indonesia—a country deeply impacted by the two diseases—is serving as patron of the summit, which will be hosted by The Union and the World Diabetes Foundation.

The summit is supported by Becton Dickinson, Eli Lilly’s Global Health Program and Qiagen. The World Health Organization is the summit’s technical partner. Jagran Pehel is the summit’s media partner.

How TB and diabetes exacerbate each other

TB and diabetes interact with each other on a number of levels, with each disease exacerbating the other. Diabetes triples a person’s risk of developing TB. Among people who are being treated for TB, those with diabetes remain contagious longer, respond less well to TB treatment and have a significantly higher likelihood of a recurrence of TB after successful treatment or dying from the disease.

TB can temporarily increase the level of blood sugar, a condition known as impaired glucose tolerance, which is a risk factor for developing diabetes. Moreover, some drugs used to treat TB (especially rifampicin) can make it more difficult to control diabetes due to the way that they interact with oral diabetes medications. There are growing concerns that oral diabetes medicines can decrease the effectiveness of TB medicines. Clinicians do not yet know how to optimise glucose control in people who have both TB and diabetes.

TB killed an estimated 1.5 million people in 2013 according to the World Health Organization—making it the world’s second-leading cause of death from an infectious disease. One in three people worldwide are living with a latent TB infection that could develop into active TB disease at some point in their lives.

Six of the 10 countries projected to have the greatest numbers of people living with diabetes by the year 2035—China, India, Brazil, Indonesia, Pakistan and the Russian Federation—are also classified as high TB-burden countries by the World Health Organization.

Source: http://www.theunion.org/