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Health Agencies, Drug Company Team To Fight Tuberculosis

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The drug company Eli Lilly and the world's leading public health agencies are joining forces to attack drug-resistant tuberculosis in countries with potentially explosive epidemics.

''This is a tremendous step forward,'' Secretary of Health and Human Services Tommy Thompson said in a telephone interview Wednesday. Thompson is scheduled to make the announcement in Geneva early today as he chairs his first board meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria. ''If we can get drugs into these countries with drug-resistant TB, we'll be able to control epidemics that are growing at an alarming rate.''

Lilly officials declined to comment on the partnership before today's announcement, but government officials said programs would likely debut in Russia and China and perhaps South Africa.

Lilly makes cycloserine, sold as Seromycin, and capreomycin sulfate, sold as Capastat sulfate, two of a precious few drugs that can kill the microbe that causes TB when it outlives other antibiotics.

The company has agreed to license drug companies in hard-hit countries to produce the two drugs at low cost, providing rights valued at about $70 million, Thompson said. The company also has given Harvard University tuberculosis experts a one-year, $1 million grant to teach Russian doctors how to use the drugs.

The World Health Organization -- another Lilly partner, along with the Centers for Disease Control and Prevention and Purdue University -- has declared TB a global emergency. TB is a progressive lung disease caused by a germ that infects 8 million people a year and kills 2 million of them. It is widespread in Russia, China and South Africa, all countries threatened by dual epidemics of AIDS and TB.

Russia's TB rates have more than doubled in the past decade, to 53 cases per 100,000 people, fueled by a prison reform program that releases scores of prisoners with TB each month, says Edward Nardell of Harvard-affiliated Partners in Health, the group that will train Russian doctors.

China's rate hovers between 100 and 300 cases per 100,000 -- 4 million Chinese are TB carriers -- and South Africa's rate is the highest in the world at 350 cases per 100,000.

The U.S. rate is about 10 per 100,000. It is higher in immigrant populations and among users of illegal drugs. In the 1990s, outbreaks of multidrug-resistant TB occurred in California and Florida, New Jersey and New York. The New York outbreak cost more than $1 billion to contain.

A Lilly-funded study in Lima, Peru, showed that the two drugs, used properly, cured 62 of 75 people with drug-resistant TB who were treated for four months, said Nardell, a lead investigator. He called the results ''astonishing.'' The standard course of treatment takes 18 to 24 months.

The drugs cause severe side effects, including liver damage, numbness, pain and nausea. ''Patients understand that it's their last chance to live,'' he said.

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