The focus on HIV/AIDS has helped forget the threat of tuberculosis

Mar 25 2008

A leading Australian expert has warned that the international attention devoted to HIV/AIDS has dwarfed the threat of tuberculosis (TB).

National University bioethicist Dr. Michael Selgelid says TB remains the second leading cause of death due to infection in the world and the emergence of untreatable drug-resistant strains is because of a lack of interest in the disease.

Dr. Selgelid says even though tuberculosis kills almost as many people as HIV/AIDS, bioethicists in rich countries have largely ignored the issue and although cures were first developed in the 1950s, there has been no new drug development in almost 40 years.

Selgelid says as a result there are no treatments for the more severe forms of TB that have emerged.

He believes the lack of a financial incentive for pharmaceutical companies to develop a product that was primarily needed by poor people with little money to spend on pharmaceutical products, is to blame.

Selgelid, a senior research fellow at the Australian National University's Public Ethics Centre, says the primary focus on HIV/AIDS and a lack of access to cheap life-saving medication has left the world facing a potential epidemic of untreatable tuberculosis.

Selgelid says the global TB status quo is shameful and more needs to be done to stop the spread of the disease.

Dr. Selgelid says one third of the world population is infected with latent TB and 10 percent of these will become active; TB kills 1.7 million people each year.

Selgelid says in the last 20 years the threat of TB has increased significantly with both Multi-Drug Resistance (MDR) TB and recently Extreme or Extensively Drug-Resistant (XDR) TB becoming more prevalent.

XDR-TB has been found in 45 countries and every region of the world and because it is virtually untreatable we are back to a situation comparable to the pre-antibiotic era.

In many poor countries where TB is often rife many people who are infected, often cannot afford to complete their treatment.

Dr. Selgelid says XDR-TB should be a wake-up call and galvanise policy makers worldwide; his comments aptly coincide with World Tuberculosis Day.

The World Health Organisation says TB is a contagious disease spread like the common cold through the air.

People who are sick with TB in their lungs are infectious and spread the disease when they cough, sneeze, talk or spit; only a small number of these bacilli need to be inhaled for a person to be infected.

Left untreated, each person with active TB disease will infect on average between 10 and 15 people every year even though they may not necessarily become sick themselves.

The WHO says every second someone in the world is newly infected with TB bacilli and people with HIV are much more likely to develop TB.

The WHO says in 2005 the South-East Asia Region accounted for 34% of TB cases globally but sub-Saharan Africa has nearly twice that with almost 350 cases per 100,000 population.