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Wednesday, March 14, 2007

Soros grant to help Boston groups battle drug-resistant TB

By John Donnelly, Globe Staff

Investor and philanthropist George Soros today announced a $3 million grant to Boston-based Partners in Health and Brigham and Women's Hospital in hopes of curbing the spread of extremely drug-resistant strains of tuberculosis in the small African nation of Lesotho.

Partners in Health, which has a decade of experience in treating drug-resistant TB in Haiti, Peru, and Russia, hopes that it can develop regimens to effectively battle these emerging strains of the disease. About five Brigham and Women's doctors will be involved in the project.

These new strains -- labelled XDR-TB -- have been found in 28 countries after an outbreak was reported last year in the Kwa-Zulu Natal province of South Africa. In that first documented outbreak, 52 of 53 patients identified with XDR-TB died. Since that outbreak, South Africa's death rate for those co-infected with HIV and the drug-resistant TB has been 85 percent.

"We were always afraid that multiple drug-resistant TB could meet HIV/AIDS and this is now happening," Soros said in a conference call with reporters. "It is not getting the attention it deserves."

The resistant TB has been found mainly in patients who have HIV, a virus that weakens a person's immune system and allows other diseases to flourish.

"It's a huge problem," said Dr. Paul Farmer, co-founder of Partners in Health and one of the world's leading experts on HIV and TB treatment in poor settings. "I do think there is some paralysis" in addressing the issue, he added.

But Farmer and Dr. Jim Yong Kim, another co-founder of Partners in Health and the former HIV/AIDS director at the World Health Organization, said they believed that the Soros gift would help spark both other funding and lead to a way of treating XDR-TB.

Kim said he hopes that the research in Lesotho -- a mountainous country surrounded completely by South Africa -- will lead to treatment guidelines in a year's time for people who have both HIV and XDR-TB. He said the process of developing treatment guidelines normally takes between three and five years.

Tuberculosis can be passed by coughing or sneezing to those in close proximity. Roughly 8 million people contract the disease every year, and an estimated 2 million die annually, including many who have AIDS. Kim said that an estimated 500,000 people worldwide have multiple drug-resistant TB, and that number could jump to 1.5 million by 2015, including many cases of XDR-TB.

"We need to get ahead of this problem," Kim said, adding that if the world didn't, it could return to "the pre-antibiotic era of TB control," with no effective medication for many patients.

Partners in Health will bring experts from Haiti and Peru to Lesotho to fight the disease. Doctors in Lesotho also will be trained. The Boston groups, which have set up quarters outside a hospital in the capital of Maseru, had been sending sputum samples to the Massachusetts state laboratory for testing, but a South African lab will now take the samples.

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