The emergence of drug-resistant strains of tuberculosis is threatening global control of the disease, Mario Raviglione, director of the World Health Organization's Stop TB Department, said Thursday at the 38th Union World Conference on Lung Health in Cape Town, South Africa, Reuters reports. "Scenarios of apocalyptic nature" related to the TB pandemic "are not likely," but they "are not ... impossible," Raviglione said, adding that about 96% of TB cases globally are treatable with the standard four-drug regimen and that 4% are multi-drug resistant. Two billion people worldwide are living with TB, and about 450,000 people have a drug-resistant strain of the disease, AFP/Yahoo! News reports. Raviglione noted that the global TB epidemic appears to be peaking at about 8.8 million new active cases annually and that death rates are leveling off.
Forty-one countries have reported at least one case of extensively drug-resistant TB, but the figure could be higher because many African countries lack laboratories that can detect XDR-TB, which is resistant to the two most potent first-line treatments and some of the available second-line drugs, Raviglione said. China, India, Russia and South Africa have the highest number of cases of MDR-TB and XDR-TB, accounting for up to 60% of the world's cases, according to Raviglione. The chance of XDR-TB becoming dominant is less than 5%, he said. "However, if you start inputting into the mathematical model a cure rate as low as it is in many countries of Africa today and the XDR epidemic not being addressed with a higher cure rate," then the 5% "becomes much more easily reachable," he added. "It is crucial to develop more efficient and reliable ways to test people so they can be treated timely, so that they can't spread the disease further," he said.
Experts at the conference said that seven new drugs are in clinical trials and that a vaccine candidate could be available in about 10 years, AFP/Yahoo! News reports. Jerald Sadoff, president of the Aeras Global TB Vaccine Foundation, said the new vaccine should be at least 70% more effective than the BCG vaccine. Giorgio Roscigno, CEO of Foundation for Innovative New Diagnostics, added that more investment, especially from governments, is needed to ensure that these sorts of efforts are successful.
Source: Kaiser Family Foundation