Tuberculosis is hardly an illness from the past as it continues to sicken and kill millions every year, particularly in developing countries.
On World TB Day, this reality exists despite nearly all cases of TB being preventable and treatable.
TB: Current Trends And Problems
TB killed 1.8 million in 2016 or 4,900 people every day, revealed a Forbes report. Drug-resistant tuberculosis remains one of the biggest threats — given its airborne transmission, the growing issue of antibiotic resistance, and people being already infectious before they are diagnosed.
Resistant strains have been dubbed by the World Health Organization (WHO) “Ebola with wings” because of their poor cure rates, which are 52 percent for multi-drug-resistant TB (MDR-TB) and 28 percent for extensively drug-resistant TB (XDR-TB).
There are 10.4 million new TB cases in the world and India carries the biggest burden of these with 27 percent. MDR-TB, on the other hand, led to some 480,000 new cases globally in 2015, with an estimated 3.5 percent of new TB cases and 20.5 percent of previously resolved TB cases falling under this category.
A majority of TB patients suffer from strains of the Mycobacterium tuberculosis in their lungs, which usually leads to painful lasting coughs, weakness, fevers, and weight loss.
Some of these mycobacteria can be transmitted from animals to humans. The human Mycobacterium bovis (M. bovis) infection, for instance, has already been nearly eliminated in North America and Europe, but still remains in rural communities lacking adequate health care and agricultural regulations.
Other species of zoonotic mycobacteria can result in TB in wildlife and livestock, and it is unidentified how risky these are for humans.
The TB epidemic also reflects poverty, malnutrition, and lack of health care access in many areas around the world.
It may be surprising, however, that the WHO did not include the disease in its recent antimicrobial resistance (AMR) priorities report — something that did not sit well with AIDS Free World’s Stephen Lewis in a keynote speech.
“A full third of the deaths from AMR are directly attributable to TB. Tuberculosis is the single greatest antimicrobial threat,” he emphasized.
Diagnosis And Global Control
Many places such as low-income nations and most of Africa still lack diagnostic capabilities. Very little research or surveillance on zoonotic TB, too, exists in spite of pastoralist African groups being most susceptible.
TB treatment can often take up to 24 months and entail daily injections and taking thousands of pills. Side effects include nausea, deafness, and psychiatric symptoms.
Out of desperation, too, some physicians try to treat XDR-TB via “drug repurposing,” or using complicated untested regimens of drugs already being marketed. One example is oral Linezolid, initially created form MRSA and VRE infections.
But there’s the promise of new potential treatments, such as drugs and several repurposed compounds that are now being proved in large Phase III clinical trials in the EndTB partnership of Partners in Health (PIH), financier UNITAID, and other entities.
According to the WHO, an added $1 billion a year at the minimum will be necessary to beef up medicine, vaccine, and diagnostic tool development against TB.