This is World Tuberculosis Day. Via The Guardian, a post on the Poverty Matters blog by Jennifer Hughes of MSF: Tuberculosis is an old disease with a new face – and it needs to be stopped. Excerpt:
Nearly half a million people across the globe are infected by strains of tuberculosis against which existing drugs are powerless. In South Africa, where I work, 15,000 people were diagnosed as having drug-resistant TB (DR-TB) in 2012. Up to 80% of them caught it by unknowingly breathing it.
When they become ill, they come to see me. At those moments, I wish I had chosen to become a schoolteacher or a city planner or engineer – surely, in such professions I would be able to make a bigger difference to people's lives.
What am I to tell my patients? That, yes, we just celebrated the cure of 30-year-old Siyabulela, but that he is one of only four patients I have treated to beat extensively drug-resistant tuberculosis (XDR-TB), which jumps to its next victim every time someone infected sneezes? That the three other people who started the same treatment at the same time are long dead?
I can't bear having to look someone in the eye and tell them that I cannot give them better odds of survival than a roll of a dice. Roll a six, you'll live; if not, you'll be dead within two years. In South Africa, only 13% of XDR-TB patients are cured by the existing treatment regimen.
I also have to tell them that, for that slim shot at survival, they will have to endure a harrowing two years of treatment. For at least the first six months, they will receive daily injections that hurt so much they will be unable to sit down, and the injected drugs could make them permanently deaf.
So limited is the medical arsenal at my disposal, another drug I may be forced to prescribe might trigger mental instability, causing psychotic episodes so acute that they could be a danger to themselves.
But, I have to explain to my patients, they will only know after two years whether it was all worth it; only then will it become clear whether their roll of the dice produced the required six.
I'm sick and tired of using plasters to patch up gaping wounds. I need something I can really work with, something that can save lives. We need a new treatment regimen against TB that actually works. Treatment that has not been dredged up from the dark ages of modern medicine and reused because, well, it's better than nothing.
There is some hope on the horizon. For the first time in 50 years, new drugs are being developed to treat TB. They represent great strides forward, but they can't be used in isolation. TB is so powerful that you need a full cocktail of drugs to beat it.
The only way to beat this disease is for governments, donors, pharmaceutical firms and research organisations to find new combinations of drugs that are simple, accessible and more tolerable than current treatment and can be implemented rapidly in countries where DR-TB is rife.
But by the time that dream is realised, 80% of the patients I see every day, who see my white doctor's coat as a life jacket, will be dead and gone, forgotten by all but their devastated families in the poorest corners of the country.