The World Health Organization is an under-appreciated institution, which often takes on critical tasks. For example, in 2011 it brokered an agreement to end a controversy about viral sample sharing particularly related to avian influenza. This agreement will greatly help with the development of pre-pandemic vaccines, but such achievements attract little press coverage. The WHO receives much more press when it acts as the world’s medical sleuth. When invited, it quickly arrives on the scene wherever a new disease is emerging. At the moment there are no fewer than three new diseases that merit the WHO’s attention. Although they may not each be the next SARS, they all have worrisome aspects.
In our book and this blog we give considerable attention to the threat posed by avian influenza, which also attracts a great deal of media coverage. But there is another, and older, threat that also deserves attention. Tuberculosis has been a growing problem. As Paul Farmer’s work has described, it flourished in Russia after the collapse of the Soviet Union, and drug resistant tuberculosis has been a growing threat from Peru to Haiti. The challenge is that if patients are not properly diagnosed, or if they fail to take a long course (a minimum of six months) of medication, the disease becomes resistant.
"Bacteria" by ddpavumba at freedigitalphotos.net
This problem has combined with the spread of HIV/AIDS, which decreases people’s resistance to TB. This led to a terrifying outbreak in KwaZulu-Natal province of South Africa, where an epidemic of extensively drug resistant (XDR) tuberculosis (TB) began spreading in 2006. From South Africa, the disease was moved into neighboring countries, such as Lesotho.
A recent news article in South Africa gives some insight into why TB was so difficult to treat. After a woman was diagnosed with XDR TB, she required intensive, inpatient care. Her family had to conduct a (successful) fund-raising campaign before she could be admitted to a hospital, where she is finally receiving the care she needs. In this case, the woman’s family rose to the challenge, and obtained care for her. But what if she had not been so fortunate? …
