The battle against tuberculosis (TB), especially drug-resistant varieties, remains volatile in China, where at least 130,000 people die from the highly contagious disease annually, a health official said.

Jiang Shiwen, a division director with the National Center for TB Control and Prevention under the Chinese Center for Disease Control and Prevention (CDC), issued the alert on Monday, the World Tuberculosis Day.

A comprehensive government TB containment initiative launched in 2005 has provided free screening and drug therapy from designated organizations for all rural and urban residents.

"About 1 million of the average 1.3 million new TB patients every year benefit from the initiative, which is funded with an annual government subsidy of 500 million yuan (US$70 million)," Jiang said.

"The rest go undiagnosed and untreated, with every one of them able to infect 10 to 15 people a year simply by coughing or sneezing."

However, drug-resistant TB strains - mainly caused by delayed treatment of common TB and capable of developing into multi-drug-resistant (MDR) ones and then extensively drug-resistant tuberculosis (XDR TB) - are not being effectively treated through the initiative because of funding constraints, he said.

Currently, nearly 1.5 million Chinese have drug-resistant TB, and 500,000 have the MDR variety, official statistics show. Many of them live in the poor countryside and cannot afford treatment, which costs about 80,000 yuan - about 20 times more than common TB.

About one in 10 of the annual new MDR-TB infections worldwide is contracted in China, according to the WHO.

"Most of the TB deaths come from this strain," Jiang said, adding the government needs to become more concerned about the issue.

"Several billion yuan is needed to handle them all," he said.

Another challenge to the efforts to contain the disease is a lack of standardized therapies for drug-resistant TB at medical institutions, Jiang said.

"It's also important to enhance drug dosage adherence among patients," he said.

(China Daily March 25, 2008)