Tuberculosis (TB) is another disease that infects people across the globe. Tuberculosis spreads through the air when people who are infected with it cough, sneeze, or speak. People infected by TB often have no symptoms of the disease. It is only when a person’s immune system is compromised that he or she develops symptomatic TB. Symptoms include a lingering cough, fever, weight loss, night sweats, loss of appetite, and fatigue.

Tuberculosis is most prevalent in areas with high population density. As economies become more industrial and less rural, urban populations grow and the conditions improve for the spread of TB. According to the CDC, In total, 11,545 TB cases (a rate of 3.8 cases per 100,000 persons) were reported in the United States in 2009. This represents a drop of 10.5% since 2008.¹⁶ 

TB is not only a problem in areas with high concentrations of people, like cities; it is also a problem in schools, where children spend a lot of time close together in classrooms, and among people with compromised immune systems. Individuals with HIV/AIDS are particularly vulnerable to catching fatal cases of TB. In fact, 24 percent of TB deaths [are] HIV associated.¹⁷ (See The Link between TB and HIV.)

Estimated TB incidence, prevalence and mortality, 2008

On the whole: TB can be cured, but treatment typically involves taking at least four different medicines over a 6-12 month period. Many TB patients are not able to follow this treatment routine, and health care systems in developing countries, in particular, often lack the staff and resources necessary to monitor TB patients effectively.

From a public health perspective, poor or incomplete treatment of diseases like TB can be more damaging than no treatment at all. Poor treatment can encourage the development of new strains of a treatable disease that are resistant to available medicines. As with malaria, a strain of TB has become drug-resistant. This strain has been labeled “MDR-TB” (multiple drug-resistant tuberculosis). This form of TB is much more difficult and costly to treat. While the typical six-month treatment for regular TB can cost $10, treatment for MDR-TB can cost $20,000 and take several years.

The strategy for treating TB recommended by the WHO is called DOTS. DOTS combines political commitment, detection, drug supplies, and monitoring services to treat and prevent the disease. According to the WHO, DOTS can produce a 95 percent cure rate, even in poor countries. In July 2001, the WHO, a non-governmental organization called Doctors without Borders, and Harvard University Medical School launched an effort to provide poor countries with affordable drugs that are effective in treating MDR-TB. The plan calls for some countries to receive medicines at prices reduced by as much as 94 percent.

In 2007, this combined effort led to its first huge success. The first Doctors without Borders patient, N.L. from Armenia, completed treatment of MDR-TB. According to Doctors without Borders Field News (November 6, 2007), “Up until two years ago, there was no medical treatment for such strains of TB in Armenia due to the complexity of the treatment, which takes at least two years, including several months of hospitalization.” Doctors without Borders are expecting many more such positive results. Says Robert Parker, MSF head of mission in Armenia: “We are now able to respond honestly to the recurrent question from our patients: ‘Does this treatment work?’ ‘Has anyone ever been cured with this treatment?‘”

16   http://www.cdc.gov/tb/statistics/default.htm