Global Disparities in Tuberculosis Treatment Highlight Need for More Research

We are reminded yet again why global health issues matter for Americans with recent news coverage of a possible tuberculosis outbreak at a Virginia high school that may have affected over 430 faculty and students. Health officials are recommending that all individuals at the school be tested for the disease.

Courtesy of CDC/ Dr. Ray Butler

Tuberculosis bacteria
Photo credit: CDC/ Dr. Ray Butler

Historically, tuberculosis has been the world’s greatest infectious killer, taking an estimated billion lives over the past 200 years. Tuberculosis remains a global threat today – in 2011 alone, the disease sickened 8.7 million people. Even more alarming is the rise of drug-resistant forms of the disease. WHO estimates that more than 5% of TB patients worldwide have multidrug resistant (MDR) TB, meaning that typical frontline drugs will not be effective. Because it is often expensive to test for drug-resistance, only a handful of patients are appropriately diagnosed so many experts estimate that this number may be even higher. Doctors are also discovering cases of extensively drug resistant (XDR) TB in which patients do not respond to a majority of existing drugs.

In light of these threats, drug-resistant TB is garnering international attention. In March, the Lancet published a special edition on drug-resistant TB, highlighting the need for international action against this global killer. Jo Chandler, an Australian journalist, also recently published a story about her own battle with the disease. She contracted it in 2011 while working on an article about the burden of TB in Papua New Guinea. While there, she documented the dismal hospital conditions and the struggle of patients who weren’t able to get access to the treatment they needed. She consoled family members who lost loved ones to the disease, but never guessed that she would become infected herself. She returned to Australia and is enduring a battery of treatments that leave her confined to a medical center where she can be monitored by nurses. However, Jo Chandler was lucky. She was not “one of the fevered, long-suffering patients [she had] seen wilt and expire while they wait for treatment.” Because she is a middle-class Australian, she had access to a world-class hospital, a team of specialists and countless drugs. She will recover from the disease because, in her words, she was “born with a ticket out.”

People in low-income countries simply lack the resources to treat drug resistant TB which is why investment in research and development is critical to develop new tools to treat people in these countries. More affordable and effective diagnostics have the potential to transform treatment plans for low-income patients, giving them life-saving options and the “ticket” that Jo Chandler was fortunate to have. As drug resistance spreads, it will be critical to develop new treatments so that we can keep up with the constantly evolving strains of TB.

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