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March 22, 2004, 9:07 a.m.
Resistance Is Deadly
Another threat to Europe?
As if Europe didn't have enough to worry about these days with terrorist attacks and concerns over wobbly-kneed democracies, a new survey released earlier this month by the World Health Organization has found that there are 300,000 new cases of drug-resistant tuberculosis a year in the world, and 79 percent of them are "superstrains," meaning they are resistant to our best currently available treatments. The BBC reported that these developments "pose a major threat to the EU."
These worrisome figures out to get greater attention later this week on World Tuberculosis Day (March 24), as this year the disease alone will claim over 2 million lives around the world.
Tuberculosis gets almost no attention in the Western media despite being the planet's most deadly infectious disease. And now a particularly deadly strain of the bacterial infection, Multi-Drug Resistant Tuberculosis (MDR-TB), is fueling the resurgence in TB fatalities.
Why is so little attention paid to the millions dying of TB and those threatened by MDR-TB? "TB has an image problem," says Dr. Lee Reichman, director of the National Tuberculosis Center in New Jersey and author of Timebomb, a sobering account of the pandemic. "It is a plague — alas, just like AIDS — that ordinary, middle-class people think they will never get, or ever be exposed to."
But that's not true. The WHO found that superstrain rates were "up to ten times the average in...Estonia, Lithuania, Latvia," according to the BBC. Those countries are set to join the EU after May 1, meaning its residents will have liberal travel privileges throughout Europe. Concern among European health officials is rising. Given the highly contagious nature of the disease — you can get it just from breathing — an outbreak of TB and MDR-TB throughout Europe would be disastrous for the United States as well, potentially harming trade and travel.
Adding to the worry is how TB often works in concert with HIV/AIDS. "People who are infected with HIV are uniquely susceptible to TB," says Dr. Reichman. Those with HIV/AIDS are 800 times more likely to have their TB activated due to weakened immunity. As Dr. Reichman says, "AIDS and TB are like gasoline and a match."
While more funding is needed in the fight, it's far more important that we fight smarter. Tackling the disease in countries — such as those in the former Soviet bloc or in Africa — in which health-care infrastructure and practices are still evolving is one of the central challenges in preventing TB from morphing into more deadly strains. Patients will typically develop MDR-TB when they take an incomplete or improper set of antibiotics designed to treat TB, allowing the virus to build up resistance.
Dr. Reichman, who has been on the frontlines of the TB fight, puts it this way: "Although it sounds harsh, anti-TB drugs must be restricted so that they are used only in good programs. Otherwise easy access to one drug or another will mean that more patients develop resistance and spread the TB."
That's why the issue of health infrastructure is so critical to combating disease around the globe. Without proper clinics, doctors, electrification, refrigeration, record keeping, and doctor-patient follow-through, the disease will metastasize.
Ultimately, increasing wealth in the developing world is the key to keeping infectious diseases under control. In the meantime, as with AIDS, preserving a thriving research and technology-based drug-development system is one of the only hopes for combating MDR-TB. And governments must work in concert with aid groups, industry, and charities to make sure treatment is thorough — and to avoid making a deadly situation worse.
— Nick Schulz is editor of TechCentralStation.com.
