One person in every two minutes is infected with the bacterial disease and one dies of it in every 10 minutes in Bangladesh, said Dr Vikarunnessa Begum, programme manager of the National TB Control Programme also the keynote speaker at the discussion in the capital.

The roundtable on "State of Tuberculosis in Bangladesh 2005", organised jointly by The Daily Star and BRAC, was held in the conference room of The Daily Star.

To cut down the prevalence of TB the speakers stressed the need for launching effective advocacy programmes and a monitoring system so that the grassroots population have access to information as well as to the facilities. They also said decentralisation of advocacy programmes and the monitoring system is important.

The Daily Star Editor Mahfuz Anam moderated the discussion while Abdul Muyeed Chowdhury, executive director of BRAC, Dr Zafrullah Chowdhury, project coordinator of Gono Shastha Nagar Hospital, Major General (Dr) ASM Matiur Rahman, chief advisor to the National HIV/AIDS Programme, Frank Matsaert, enterprise advisor to the Department for International Development (DFID) of the government of the United Kingdom participated.

Dr Vikarunnessa in her keynote paper said Bangladesh is one of the top five highly TB affected countries in the world. A total of 70,000 TB infected persons die each year and 300,000 new TB cases are expected every year in the country. Globally, one third of the world population is already infected with TB, while more than 10 million develop TB each year, she said.

Dr Vikarunnessa said the present TB detection rate is 46 percent while the rate of successful cure was 85 percent in 2004. The disease is more prevalent in males than in females, she said.

The National TB Programme (NTP) mobilises resources through effective partnership to ensure quality diagnostic and treatment services under directly observed treatment strategy (DOTS) to fight the spread of the disease, she said.

The DOTS is ensured at upazila health complexes, by NGOs, hospitals and community members, she added.

Abdul Muyeed Chowdhury, executive director of BRAC, said monitoring and advocacy have to be decentralised down to the union parishad level.

The public-private partnership is weak, which should be strengthened by including more partners to curb the spread of the disease, he said.

Dr Zafrullah Chowdhury said medication and hospitalisation is not the ultimate solution, instead raising of social awareness about medical problems is needed to control the spread of the disease.

He stressed the need for special training on TB for healthcare professionals including doctors, nurses and paramedics.

All the necessary information on TB should be available in Bangla for the sake of the common people, he added.

Major General (Dr) ASM Matiur Rahman said the prevalence of TB is still on the rise due to illiteracy, malnutrition and poverty. On TB detection, he said only sputum smear test is not sufficient, other methods should also be incorporated.

Dr Abdul Hamid Salim, country director of Damien Foundation, said due to lack of social awareness among the poorest section of the population TB patients are not coming to the clinics despite offers of free treatment and drugs.

Afsan Chowdhury, director of the advocacy and human rights unit of BRAC, said "We have a public-private partnership in place but it is weak. We need to build a strong partnership."

Faruque Ahmed, director of the health programme of BRAC, emphasised the need for making the healthcare system more functional so that the partnership does not remain limited only between the donors and service providers.

He also said healthcare service providers should include the affected communities into the partnership.

Frank Matsaert of the DFID said as 60 percent of the TB cases are still undetected it should be a priority to detect those cases.

The Daily Star Editor Mahfuz Anam stressed the need for developing effective ways for advocacy programmes for holistic healthcare, as it has not been successfully emphasised yet.

He concluded by saying there is a tremendous scope for amassing national resources for advocacy programmes on holistic healthcare approaches by involving the mass media.

Among others, Dr Duangvadee Sungkhobol, representative of WHO in Bangladesh, Dr Peter Herzig, health advisor to the delegation of the European Commission, Dr Dinesh Nair, health specialist of the World Bank, Dr Salahuddin Ahmed of BRAC University, Dr Asif Mujtaba Mahmud of National Institute of Diseases of Chest and Hospital (NIDCH), Dr AKM Shamsul Haq, former director of NIDCH, Dr Mirza Mohammad Hiron, president of Chest and Heart Association, Dr M Amanullah MP, Dr Tahmina Aziz, director of National TB Control Programme (NTP), and Dr Abbas Bhuiyan of the ICDDRB also took part in the discussion.