Drug-resistant TB may 'spiral out of control,' U.N. says

April 2, 2009 By Tim Johnson

The world is on the cusp of an explosion of drug-resistant tuberculosis cases that could deluge hospitals and leave physicians fighting a nearly untreatable malady with little help from modern drugs, global experts said Wednesday.

"The situation is already alarming, and poised to grow much worse very quickly," said Dr. Margaret Chan, the director-general of the World Health Organization.

With Bill Gates at her side, Chan urged health officials from 27 countries at a three-day forum in Beijing on to recognize the warning signs of what looms ahead, saying that traditional drugs are useless against some strains of and health-care costs for treating those strains can be 100 to 200 times more than for regular tuberculosis.

"This is a situation set to spiral out of control. Call it what you may: a time bomb or a powder keg. Any way you look at it, this is a potentially explosive situation," Chan warned.

Gates, the software magnate turned philanthropist, said scientific overconfidence had led to a lack of innovation and urgency in fighting tuberculosis, which affects 9 million people each year, killing nearly 2 million of them.

"The most commonly used diagnostic test is today more than 125 years old," Gates said. "The vaccine was developed more than 80 years ago, and drugs have not changed in 50 years."

Tuberculosis is a highly contagious bacterial infection that attacks the lungs and can affect other organs as well. Coughing, sneezing and even talking can spread the bacteria. If untreated, a person with TB can infect 10 to 15 other people in a year.

Once thought conquered in developed countries, virulent forms of tuberculosis are again on the march, caused often by improper use of drugs and poorly managed treatment regimes. It remains largely a disease of poverty.

Chan said that traditional treatment often left the patient wishing to end the medicine.

"Instead of taking two to four pills, one has to take 13 pills. Put yourself in the position of the patient. Thirteen pills are not 13 candies," Chan said, noting that courses of treatment can last four to six months and patients don't like the hassle of taking the pills for so long.

Outbreaks of multi-drug-resistant strains of tuberculosis are highest in India, China, Russia, South Africa and Bangladesh. Scientists now see even worse strains, which they label extensively drug-resistant TB, that can be treated neither with the two principal anti-TB drugs nor with more expensive second-line drugs.

In early 2007, 20 countries reported cases of the more fatal TB. By the end of last year, 54 countries reported the malady.

Jorge Sampaio, the U.N. secretary general's special envoy to halt TB, called the extensively drug-resistant strain "a very deadly and devastating epidemic."

Later in the day, Gates offered a grant of $33 million to China's Ministry of Health to finance what he called an innovative pilot program for TB prevention that other nations could use. The program uses new systems to reduce pill intake, offers incentives for doctors to monitor TB and pays for the development of new diagnostic tests.

China has about 1.5 million cases of TB each year.

Under the pilot program, TB patients will get medicine kits with built-in reminder alarms as well as receive cell-phone text messages reminding them to take their medicines.

Gates said that his Bill & Melinda Gates Foundation was financing research on a new TB vaccine and that "it'll be about five to six years from now before we could have a completely new vaccine."


(c) 2009, McClatchy-Tribune Information Services.
Visit the McClatchy Washington Bureau on the World Wide Web at www.mcclatchydc.com>

Explore further: WHO warns of drug-resistant TB

Related Stories

WHO warns of drug-resistant TB

September 6, 2006

The World Health Organization in Switzerland has warned of a new strain of tuberculosis that is rapidly spreading and cannot be treated with current drugs.

Drug-resistant TB on rise in Africa

November 10, 2006

Drug-resistant tuberculosis strains in Africa could kill millions of people and render useless expensive drugs protecting HIV-infected patients from TB.

HIV/AIDS linked to drug resistant TB

November 16, 2006

U.S. scientists say a highly drug-resistant form of tuberculosis has been linked to HIV/AIDS in a study conducted in rural South Africa.

Drug-resistant tuberculosis rife in China

December 11, 2008

Levels of drug-resistant tuberculosis (TB) in China are nearly twice the global average. Nationwide research published in the open access journal BMC Infectious Diseases has shown that almost 10% of Chinese TB cases are resistant ...

WHO: Money, drugs needed to rein in new TB strains

March 23, 2009

(AP) -- More money and better science are urgently needed to rein in new strains of tuberculosis that are tough or nearly impossible to treat, the WHO announced Monday in China, where the disease has long been a leading ...

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

(PhysOrg.com) -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.