The world-famous Turkish pulmonologist: "We plan to establish cooperation especially with the Turkic states and with the countries of Asia and Africa"

Interview with Professor Zeki Kilicaslan, lecturer at the Chapa Faculty of Medicine at Istanbul University, President of the NGO Istanbul Tuberculosis Control Association, with Turan News Agency

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Turan: You are known as a scientist, the president of an NGO that has been  fighting against tuberculosis all over the world for many years. You did not want to be elected to the Mejlis, although you were a member of the main opposition party for two terms. A congress of the NGO you lead will take place in almost 20 days. What kind of work should be done in the world to successfully combat tuberculosis?

Kilicaslan: Tuberculosis is still a serious problem and threat to the whole world, and the fight against it is of strategic importance. At the 2018 meeting of ministers of the world held in Moscow, this issue was widely discussed, and methods of struggle were identified. The only topic of the UN congress held in 2021 was the fight against tuberculosis.  The holding of the International Tuberculosis Congress in September 2023 also indicates that this issue is still on the global agenda. And Turkiye is one of the countries that have succeeded in solving it. The fight against tuberculosis, which began in the last period of the Ottoman Empire, was continued after the creation of the Republic, has been supported by the state since the 1950s and has borne fruit. 

Nowadays, many countries of the world are adopting the experience of Turkiye, and the role of its NGOs, whose activities are supported by state institutions on the basis of special laws, is great in this success. Although later the Ministry of Health took over the lion's share of the fight against tuberculosis, today work in this area continues together with NGOs. Now we are helping to fight this disease in less developed countries, as there are still certain problems in this area in Africa, Southeast Asia, India, Bangladesh, Pakistan, the Philippines, the Turkic republics of Central Asia and Azerbaijan.

In the absence of systematic treatment, bacteria acquire resistance, which leads to multiple – 300-500 times! – the increase in the cost of treatment. This serious problem is observed in all post-Soviet countries, where prices for new drugs are so high that the priority here should be treatment with overcoming bacterial resistance. This can be achieved through medical and social measures, although social issues should be in the foreground.

Charitable organizations can be established in the countries of Central Asia, Africa and other regions. But the current clinical situation in these regions is such that expensive drugs must be used for effective therapy, although it would be necessary to change the system and develop methods in which the patient and social protection will be at the center of these works. Turkiye has experience in this area, and it should be shared with other countries, first of all, neighboring countries, and then with countries in Africa and Southeast Asia.

Naturally, we want to carry out this work in cooperation with the Ministries of Health of Turkiye and these countries. We can improve the programs available in this area and conduct theoretical and practical classes for specialists.

In addition to the Istanbul Tuberculosis Control Association, similar structures have been established in other vilayats. We can mobilize our specialized hospitals and dispensaries to treat patients. I assure you that most of our specialists are eager to participate in this matter.

Turan: The congress of your association will be held in the next few days. Will these plans of yours be on his agenda?

Kilicaslan: I will talk about them in my report at the congress.  We have repeatedly updated these issues before. However, the pandemic has slowed down the implementation of some of our plans. We are ready to cooperate abroad with the Red Crescent Society, TIKA (Turkish Agency for Cooperation and Coordination – ed.). Turkiye needs to continue to step up this work and share its experience with foreign countries.

Turan: Do you receive foreign information from the World Health Organization (WHO) or through direct contacts you have established?

Kilicaslan: WHO has a Tuberculosis Control Department, and there is also an International Tuberculosis Control Association. We are related organizations with them, we participate in their meetings. We get most of the information from them.

Turan: You are constantly concerned about the problems of protecting the health of migrants in Turkiye, and now you are preparing to combine all the work carried out in this area under the auspices of your association. What can you say about this?

Kilicaslan: For us, the priority is the health of every person, regardless of their nationality. Earlier, we achieved the prohibition of some types of production harmful to health.  Today, in Istanbul, out of every 100 tuberculosis patients, 25 people are migrants, and in the Zeitunburnu hospital – 40, in the Fateh hospital – 35 people. We believe that everyone has used medical services equally, and therefore we continue to fight against tuberculosis together with our colleagues.

Turan: We have heard that you are going to open a medical center with international support for this purpose. What would you like to say about this?

Kilicaslan: Most migrants do not have an official residence permit and therefore they cannot go to hospitals. In addition, treatment costs 4-5 times more for migrants without medical insurance. To prevent this, we plan to open a consulting and diagnostic center.

Turan: Which countries of the former USSR did you visit in order to share your experience? Have you been contacted with a request for cooperation?

Kilicaslan: Yes, I visited Azerbaijan, where we discussed ways to cooperate with our colleagues in the fight against tuberculosis. However, this work must be carried out on an ongoing basis, and for this we need your support.

Turan: We are always ready for this. If you want to add anything else, please.

Kilicaslan: Tuberculosis is a shame for humanity. Despite the availability of medicines and vaccines, this problem has still not been solved, although the disease has existed for 1000 years. Unfortunately, however, a sufficiently effective vaccine has not yet been created. Let me remind you: 1 year after the Covid-19 pandemic, several effective vaccines were found. Then why can't we develop a truly effective vaccine against this disease?

Unfortunately, this is largely due to the fact that tuberculosis is a disease of the poor  countries. Although States should allocate adequate financial resources for the creation of new vaccines. The development of an effective vaccine against tuberculosis is our most basic requirement.