A lab technician holds up a
sputum sample containing
Photo credit: Gary Hampton/The Global Fund
When the World Health Organization announced in 1993 that tuberculosis (TB) should be treated as a global emergency, the international community's response was slow and uncoordinated.
Although initial progress has since been made in controlling the disease, the emergence of a deadly HIV–TB co-infection epidemic and extensively drug-resistant strains of TB means that a more serious and aggressive strategy is essential to fight the world's second biggest infectious disease.
What needs to be done? More research is undoubtedly necessary. Understanding the social factors deterring people from seeking diagnosis or treatment, removing the barriers to accessing care, and devising new strategies to diagnose TB in children and HIV/AIDS patients are key priorities.
When the genome of the bacterium that causes TB has been sequenced, researchers will be able to look for ways to defeat it. Understanding immunity to the disease may also help researchers who have so far been frustrated in efforts to develop a new, long-lasting vaccine.
But there are practical measures that can be implemented using existing knowledge: integrating TB and HIV efforts — especially in sub-Saharan Africa — and strengthening health systems are just two examples.
Two-thirds of TB cases could be detected with existing diagnostic methods if only these techniques were widely and effectively implemented. These measures will need tremendous national commitment as well as international support and guidance.
Need for information
Just as important as these actions is the need for accurate information. This means not only training healthcare workers to understand the growing challenges of TB, but also educating the wider population to dispel any lingering myths about TB and combat the stigma associated with this disease. Raising awareness of the increased risk of TB infection for people with HIV and helping people know when they might be at risk of having latent or 'hidden' TB, are also key.
This spotlight offers the simple facts and figures about TB but also delves into more complex issues — in particular, the obstacles confronting mandatory quarantine of patients with drug-resistant TB, the problem of overlapping HIV and TB epidemics and the clinical challenges for drug development. For those wanting to read further, the spotlight also offers a comprehensive summary of websites and key reports.
Health consultant, SciDev.Net