On October 28th 2015, the World Health Organization (WHO) released a press statement that announced Tuberculosis (TB) now rivals HIV/AIDS as the leading cause of death worldwide. Tuberculosis causes 1.5 million deaths across the globe annually. The good news is that, overall, the rate of death from Tuberculosis in 2015 has decreased by 50% since 1990. However, there is a rapidly growing problem with cases of multidrug resistant tuberculosis (MDR-TB) and extensive drug resistant tuberculosis (XDR-TB).
What is MDR/XDR-TB?
Multidrug resistant tuberculosis (MDR-TB) is resistant to Isoniazid and Rifampin, two of the most commonly prescribed, first-line, drugs to treat TB. Extensively drug resistant tuberculosis is an even more rare form of MDR-TB that is not only resistant to Isoniazid and Rifampin, but also resistant to Fluoroquinolsones and one of the second-line treatment drugs (1). Due to resistance, patients with MDR/XDR-TB are left with less effective treatment options, placing them at an increased risk of death.
The WHO reported that of the approximately 480,000 global cases of MDR-TB in 2014, it is estimated that only one in four (123,000) were detected. The three largest nations with MDR-TB cases include China, India, and Russia (2).
The WHO states that the emerging problem of MDR-TB is evolving due to the mismanagement of TB treatment and transmission. When patients infected with TB do not follow the strict 6-month drug regimen for treatment, take ineffective combinations of TB treatment drugs, or end treatment early, they are at-risk of developing drug resistance TB. This drug resistant TB can then be transmitted to others through direct person-to-person contact (3).
What Needs To Be Done
In order to control the emerging MDR/XDR-TB problem, a massive push to increase funding for further research on multidrug resistance tuberculosis is required. To highlight the desperate research funding situation, the $8 million in international funding is annually allocated for HIV/AIDS, while TB funding totals merely $800,000 (4).
The disproportion in funding between these two leading causes of death has been attributed to the geographic locations that they affect. While HIV/AIDS has the highest prevalence in resource-poor countries, TB has the highest prevalence in nations such as India and China, which are considered more able to financially support disease control and prevention efforts (4).
Steps Forward
The International AIDS Society recently announced a new worldwide TB conference that will be held in conjunction with the annual AIDS. This conference may help redirect international focus to MDR/XDR-TB research (5). To find out more on the TB 2016 conference: http://www.tb2016.org/
Tuberculosis is a treatable and curable disease; however, we still have a long way to go before this disease is eradicated. Facing the growing threat of MDR/XDR-TB, tuberculosis research and funding needs to be on the global agenda.
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Sources
(1) http://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm
(2) http://www.who.int/mediacentre/news/releases/2015/tuberculosis-mortality/en/
(3) http://www.who.int/features/qa/79/en/
(4) http://www.reuters.com/article/2015/10/28/us-health-tuberculosis-global-idUSKCN0SM1Z520151028
http://www.who.int/tb/challenges/mdr/mdr_tb_factsheet.pdf?ua=1 (5)http://www.iasociety.org/Web/WebContent/File/TB2016_press_release_VOct20.pdf
Other Sources Referenced
(6) http://www.npr.org/sections/goatsandsoda/2015/10/28/452565249/tb-is-now-the-top-infectious-killer-even-though-deaths-are-down
(7) http://www.usnews.com/news/articles/2015/10/28/tuberculosis-passes-hiv-as-no-1-infectious-disease
