Vietnam and Australia join forces to fight ancient killer

Australian and Vietnamese medical researchers are meeting in Sydney this week to plan their next move against tuberculosis (TB), a disease that once was Australia’s top killer and still kills 54,000 people each year in Vietnam.

The researchers are coming together in Australia to share their progress and build stronger ties in fighting a disease which threatens Australia through its presence in neighbouring countries.

Centenary Institute’s Dr Greg Fox, who lives, works and drives two major research projects in Vietnam, is available for interview, as is Vietnam’s National Tuberculosis Program deputy head Dr Nguyen Viet Nhung.

Both can speak about the impact Australian-supported research is having on TB.

We still don’t know why only one in ten of the two billion people carrying the Mycobacteria tuberculosis bacterium become sick with TB. But the disease kills more than a million people worldwide every year – or about three every minute.

By meeting, sharing research and planning with their Australian counterparts, Vietnam’s National Tuberculosis Program deputy head Nguyen Viet Nhung and his delegation are helping to defeat this scourge in Vietnam, where 290,000 people are living with TB.

While they are here, Dr Nhung and his colleagues will present their work (including surveys of disease rates), spend a day each at the Centenary Institute and Woolcock Institute in Sydney, and set an agenda for their research over the next three to five years.

“Vietnam has some of the highest rates of TB in Asia. Australia can play a role in combating TB there as we have already done in our own country,” Centenary Institute researcher Dr Greg Fox says.

Greg, who usually lives and works in Vietnam, has been key to many of the projects being discussed this week including his genetic study of TB patients and their families.

“Because of the high number of cases of TB in Vietnam, we can compare genetic differences between those affected by TB and those who aren’t,” Greg says, “This may one day allow us to identify the one in ten of us at greatest risk of being affected by TB.”

His other research project is a $1.3m NHMRC-funded collaboration between Centenary and the Woolcock Institute that set up a controlled trial of active screening of TB patient’s family members in 71 District Clinics in eight provinces across Vietnam.

In his work, Greg collaborates with the National Lung Hospital in Hanoi and the Pham Ngoc Thac Hospital in Ho Chi Minh City as part of Vietnam’s National Tuberculosis Program, members of which are part of the delegation visiting Australia.

“We commend our Vietnamese colleagues for their efforts to fight TB and we’re delighted to be able to help them. It is vital that Australia continues to support the fight against TB in Vietnam, China and across the Asia-Pacific region,” Professor Mathew Vadas, the Director of the Centenary Institute says.

This week the Vietnamese guests attended a  reception dinner with Vietnam’s Consul-General, His Excellency Mr Mai Phuoc Dzung, and Faculty of Medicine Dean at the University of Sydney, Professor Bruce Robinson.  The dinner was hosted by Centenary Institute’s Professor Warwick Britton and Woolcock’s Professor Guy Marks.

For interviews contact:  Suzie Graham on (02) 9565 6166.

• Nguyen Viet Nhung is in Australia until Friday. Greg is in Sydney this week, but is usually based in Vietnam.

Background:

• Tuberculosis (TB) is a disease that is caused by a bacterium called Mycobacterium tuberculosis.
• TB infection attacks the lungs, but can also have an impact on other areas of the body.
• TB is spread when a person with an active pulmonary infection sneezes, coughs, spits or simply speaks. Like the common cold, infectious droplets are sprayed into the air and can be inhaled by people nearby.
• Two billion people carry TB bacteria, with no symptoms—but one in 10 of them will develop active TB. They will become contagious and be at risk of serious illness and death.

Current treatments and efforts

• TB bacteria can usually be treated with a course of four standard antibiotics, known as ‘first line’ drugs, taken over six months or more.
• Multi-drug resistant TB (MDR-TB) is spreading.
• This takes longer to treat and can only be cured by ‘second-line’ drugs.
• Even tougher forms of TB are starting to appear. There are no effective drugs against these extensively drug-resistant forms of TB (XDR-TB).
• The World Health Organisation (WHO) estimates that there may be as many as 25,000 cases of XDR-TB. Most cases are fatal.

TB globally and in the region

• Per capita, the global TB incidence rate is falling, but the rate of decline is very slow – less than 1%. There were 9.4 million new TB cases worldwide in 2009.
• 22 countries account for 80% of the tuberculosis cases in the world.
• A third of all new cases are in India and China.

TB in Vietnam

• In 2010: 29,000 died from TB, and 290,000 people are living with TB.
• 175 000 new infections per year.
• The Vietnamese government declared TB a national priority in 1995.
• Figures from Vietnam’s Ministry of Health (MOH) show detection and cure rates are well above the global targets set by the WHO

The incidence of TB in Australia has remained at a stable rate since 1986. A total of 1,135 cases of TB were reported in Australia in 2007, representing a crude rate of 5.4 cases per 100,000 population. In 1960, the rate was closer to 40 per 100,000. But TB is already expanding its reach into Australia via our closest neighbour Papua New Guinea (PNG). The rate of TB in PNG has increased by 42 per cent in the past decade and is still rising, according to national health data. The WHO estimates about 3600 people in PNG die from TB every year, though uncertainties around surveillance and diagnosis mean the toll may well be higher.

Greg Fox, an Australian medical doctor and PhD student, never thought his TB research would lead him to strap research papers to his back and ride around the Vietnamese countryside on a moped to visit research sites and train local doctors. Greg now lives in Hanoi, working on TB genetics and other risk factors, for Centenary Institute and Woolcock Institute at the National Lung Hospital.  The joint project is funded by the NHMRC (Grant ID: 632781). More on Greg here: http://bit.ly/wdtBWf

The Centenary Institute is an independent leader in medical research seeking improved treatments and cures for cancer, cardiovascular and infectious diseases. We are working to discover new prevention, early diagnosis and treatment options to enable each generation to live longer, healthier lives than the one before. Centenary’s affiliation with the RPA Hospital and the University of Sydney means that our discoveries can be quickly applied to the fight against disease in the clinic.  More at: http://www.centenary.org.au/

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