The 24th March is my husband's birthday - it is also World TB Day - not a day that most people know about, I suspect. However, TB is a growing global problem. TB or tuberculosis still kills about 4000 people a day - that's an appalling figure and one that we should be ashamed of in a world where you can find half a dozen different versions of the same drug to treat hypertension, for example. And, alarmingly, according to the WHO report, Global tuberculosis control 2008, the pace of progress to control the global TB epidemic actually slowed slightly in 2006 - the most recent year for which full statistics are available. The main slow down is in diagnosis. Apparently some national programmes are no longer managing to keep up the pace that they managed in the first five years of their inception. And in sub-Saharan Africa - where the dual pandemic of TB and HIV is taking its toll - there has been no increase at all in diagnosis in national programmes. There appear to be two main barriers to progress. The first is the increase in multidrug resistant TB, reported by the WHO in February 2008 to have reached the highest levels ever recorded. The second is the lethal combination of TB and HIV - in which some countries are managing to take steps - notably Rwanda, Malawi and Kenya - all of whom have achieved the highest rates of HIV testing among TB patients. Note that South Africa is not on this list. The increase in the incidence of multidrug resistant TB is alarming, because many of these patients die - we simply do not have the drugs or the resources to treat them. New diagnostic tests and new drugs are urgently needed. TB is a neglected disease for the simple reason that most people who suffer and die from it are poor - so pharmaceutical companies won't make any money out of developing new drugs. It has taken private money from peoeple such as Bill Gates to encourage any interest at all in the disease. However, the BBC recently reported a case of multidrug resistant TB in a Somali immigrant to Scotland. Perhaps it will take a resurgance of the disease in the West before more money will be put into research into new approaches to treatment. My more cynical side thinks that a more likely result is a further tightening of immigration regulations, however.
Bridget Farham Editor https://www.bizcommunity.com