The World Heath Organization has released the results of a four-year study of patients in 81 countries which shows that rates of multidrug-resistant tuberculosis (MDR-TB) are at their highest levels yet recorded. Extremely drug-resistant tuberculosis, which is nearly untreatable, has appeared in 45 of those countries. At face value, this sounds like bad news, but the true global reality may be even worse. Only six nations in Africa, where tuberculosis has the highest incidence, were able to provide any data.
Tuberculosis is notoriously difficult to treat in areas where resources for medicine and doctors are scarce. Supplies and personnel are doubtless important, but effective patient management is especially necessary when it comes to TB. As we all know from having taken antibiotics, finishing the entirety of the prescription, even if you feel better, is crucial to defeating the infection. For those infected with MDR-TB, this is even more critical. When follow-up care can’t be easily implemented, the success of treatment programs is tenuous at best.
For an excellent introduction to the challenges of treating tuberculosis in the developing world, pick up a copy of Mountains Beyond Mountains, by Tracey Kidder. It’s the story of Dr. Paul Farmer’s quest to provide medical service, in particular to treat MDR-TB, for the desperately poor in Haiti and elsewhere. A two sentence summary, unfortunately, does not do this book justice. Farmer has become an inspirational figure through his work and Kidder’s story eloquently bears that out.