Amidst the disaster in Japan, what looks a lot like war in Libya, other developments in the Middle East, and so on, “World TB day,” didn’t get much attention today. Even the WHO’s home page top story concerns the efforts to address the damage from the March 11 natural disasters. And of course, that makes a lot of sense given the crisis and desperation of the situation. But it also reminds me of the longstanding challenge of addressing global health threats like TB: it is rare that any single news event will capture the public imagination and elicit a wide response. Rather, as was the case with HIV/AIDS, attention must be created through steady activism and pressure. However, particularly with relatively slow moving epidemics, that momentum often doesn’t build until the human tolls are staggering, and we find ourselves looking back and saying, “if only…” At the moment, I can’t help but find myself concerned about the stream of reports about drug resistant tuberculosis. Intrinsically bad, MDR and XDR (extremely drug resistant) strains exacerbate the severity of HIV epidemics, especially in high-burden countries, where there is substantial co-infection such as in South Africa.
Reuters reports that the WHO estimates that 2 million people will contact some form of MDR TB by 2015 (Reuters), and not surprisingly, the spread continues in places where there is a lack of diagnostic and treatment infrastructure… which in turn is likely to lead to the development of increased drug resistance.
TB is an “old” disease, and has never garnered the activist energy that helped propel HIV/AIDS onto the global agenda. It nicely rode the coattails of such activism – regard the Global Fund for HIV, TB and Malaria… But given my sense of some global fatigue with spending on the AIDS pandemic, TB advocates may need to really launch their own heroic campaign to support the goal of universal detection and treatment of MDR-TB.