Saturday, October 4, 2008

XDR TB: The Forgotten Plague

The dangers of another health epidemic (Extensively Drug-Resistant TB). The good news is that it is preventable but more consolidated effort and funding/aid from the international community is needed. No time to debate the ideological differences between Sachs and Easterly; the danger is real, it is preventable, and it needs to be done now so that no more lives are perished. The methodology and supervision of effective use of funding/aid is, however, debatable. Sometimes sub-optimal outcomes can be better and can save lives while cruising on an ideological debate for optimal aid spending.

In 2005 the disease was diagnosed in 9.2 million more people, almost exclusively in the developing world, and 1.7 million people died from it. More alarming is a growing subset of TB cases, estimated at half a million, that are resistant to more than one of the handful of anti-TB drugs. While they still make up only 5% of the total annual TB burden, these cases of multidrug-resistant and extensively drug-resistant TB are mushrooming, fueled by the surge in AIDS and by health-care systems that have ignored the threat of TB for too long.

But it doesn't have to be this way. TB is an entirely preventable and treatable disease. And the drug-resistant strains beginning to emerge in Africa, Russia, China and India, say experts, are epidemics of our own making. Unlike HIV, the tubercle bacillus succumbs to powerful medications. But these drugs are not where they need to be, and when they are, spotty monitoring and poor health infrastructure make it hard to ensure that patients take their daily doses for the six months that are needed to eradicate the infection--all of which encourages drug-resistant strains to survive and keep the disease going.