Nobody Should Die From TB

March 25th is World TB Day. Now, in truth, every day seems devoted to something that is really important in one way or another, but when you know how to control a disease, it seems almost criminal that people keep dying anyway. USAID, which spends money on these issues, offers these general statistics:

Despite being curable, tuberculosis (TB) remains an enormous global public health issue. Of the 9 million people a year who get sick with TB, a third are “missed” by public health systems. The majority of these 3 million are the most poor and vulnerable.

TB is a contagious bacterial airborne disease that claims a life every 18 seconds. TB knows no boundaries or borders, making it a global health emergency that must be addressed with immediate and aggressive action.

Not coincidentally, today's NYTimes has a story, based on an open source article in The Lancet, about China's success in bringing down (albeit nothing close to zero) TB cases in that country.

China has cut its rate of tuberculosis by more than half over the last 20 years, according to health officials there.

Its success shows that the tuberculosis-fighting strategy endorsed by the World Health Organization in 1995 works well if it is rigorously applied.

The strategy — called DOTS, for directly observed therapy, short course — requires that every case be diagnosed by sputum sample, and every patient be given a standard regimen of four antibiotics to take daily for about six months, and be watched taking the pills every day. The observer can be a nurse, a family member, a neighbor or any other trusted person.

Having known a person who returned from Latin America with with TB many years ago, I can attest to the fact that following that medical regime was the big issue that her parents faced every day. Not getting rid of the disease makes you a carrier of the stronger surviving bacteria, and that is dangerous to everyone else.

But China is not yet out of the woods: "China still has a huge TB problem, with a million new cases every year, 11 percent of the world’s caseload." We talk about China getting old before it gets rich. We have to hope it gets rid of TB before it gets either old or rich.