Ending apathy in an age of tuberculosis drug resistance

March 25, 2008

A primary focus on AIDS and lack of access to cheap life-saving medication has left the world potentially facing an epidemic of virtually untreatable tuberculosis (TB), an ANU academic has warned.

Senior Research Fellow at thSenior Research Fellow at the University’s Centre for Applied Philosophy and Public Ethics, Dr Michael Selgelid is warning on World TB Day (March 24) that more needs to be done to stop the spread of TB – a disease that still kills 1.7 million people each year.

Dr Selgelid said that it was a disgrace that more than 50 years after a cure for TB was found, the disease should still cause such a large death toll around the world.

“The global TB status quo is shameful,” said Dr Selgelid. “Though cures have existed since the 1950s, TB is still the second leading infectious cause of mortality – a close runner up to AIDS. One third of the world population is infected with latent TB and 10 per cent of these are expected to develop active illness at some time in their lives.”

The threat of TB has increased significantly in the last 20 years, first through the detection of Multi-Drug Resistance (MDR) TB and recently through ‘Extreme’ or ‘Extensively’ Drug-Resistant (XDR) TB. XDR-TB, said Dr Selgelid, has been found in 45 countries and every region of the world.

“Because XDR-TB is virtually untreatable we have returned to a situation analogous to the pre-antibiotic era. This has occurred for a number of reasons, including that not enough people in developing countries could afford to complete their treatment.

“It’s astonishing that TB has largely escaped the attention of bioethicists. A medical literature database search found 2998 publications addressing AIDS, but only 179 addressing TB and ethics. But while AIDS has been highly politicised, TB has primarily affected the poor so there hasn’t been as much advocacy of TB control in the rich countries where most bioethicists work.”

He added that with World TB Day approaching and the threat of XDR-TB, renewed efforts needed to be made to address the problem.

“XDR-TB should be a wake-up call and galvanise policy makers worldwide. Developed countries must do more to improve health care in developing countries. In addition to the moral imperative to easing the untold suffering and millions of unnecessary deaths, there are straightforward self-interested reasons – bad health in poor countries jeopardises the health of populations in Australia and other rich countries.

“World TB Day should remind us that it’s high time to stop TB – it could and should have been stopped long ago.”

e University’s Centre for Applied Philosophy and Public Ethics, Dr Michael Selgelid is warning on World TB Day (March 24) that more needs to be done to stop the spread of TB – a disease that still kills 1.7 million people each year.

Dr Selgelid said that it was a disgrace that more than 50 years after a cure for TB was found, the disease should still cause such a large death toll around the world.

“The global TB status quo is shameful,” said Dr Selgelid. “Though cures have existed since the 1950s, TB is still the second leading infectious cause of mortality – a close runner up to AIDS. One third of the world population is infected with latent TB and 10 per cent of these are expected to develop active illness at some time in their lives.”

The threat of TB has increased significantly in the last 20 years, first through the detection of Multi-Drug Resistance (MDR) TB and recently through ‘Extreme’ or ‘Extensively’ Drug-Resistant (XDR) TB. XDR-TB, said Dr Selgelid, has been found in 45 countries and every region of the world.

“Because XDR-TB is virtually untreatable we have returned to a situation analogous to the pre-antibiotic era. This has occurred for a number of reasons, including that not enough people in developing countries could afford to complete their treatment.

“It’s astonishing that TB has largely escaped the attention of bioethicists. A medical literature database search found 2998 publications addressing AIDS, but only 179 addressing TB and ethics. But while AIDS has been highly politicised, TB has primarily affected the poor so there hasn’t been as much advocacy of TB control in the rich countries where most bioethicists work.”

He added that with World TB Day approaching and the threat of XDR-TB, renewed efforts needed to be made to address the problem.

“XDR-TB should be a wake-up call and galvanise policy makers worldwide. Developed countries must do more to improve health care in developing countries. In addition to the moral imperative to easing the untold suffering and millions of unnecessary deaths, there are straightforward self-interested reasons – bad health in poor countries jeopardises the health of populations in Australia and other rich countries.

“World TB Day should remind us that it’s high time to stop TB – it could and should have been stopped long ago.”

Source: ANU