TUBERCULOSIS: TB 'generations' from eradication

REBECCA LINDELL, Postmedia News December 31, 2010 Poverty, lack of investment in diagnostic tools and treatment undermine a cure, director says

Despite 100 years of medical advances, the world is still a long way from exorcising the medical "demon" of tuberculosis, according to medical experts.
Finding a cure for the deadly lung-afflicting disease was one of the great hopes expressed by Squire Sprigge in 1911 in the first editorial of The Lancet -the prominent British medical journal. Entitled "The Promise of 1911," Sprigge wrote he hoped "better understanding would one day result in the mastery of the disease."
In Canada, TB still ravages First Nations communities. Data from the Public Health Agency of Canada shows the TB rate among Inuit is 185 times higher than that of other Canadians.
The rate among First Nations - Inuit and Metis are not included in First Nation groups -is 31 times higher than the general population.
Worldwide, nine million new cases are diagnosed annually and at least 1.5 million people succumb to the disease every year, said I.D. Rusen, a project director with the International Union Against Tuberculosis and Lung Disease.
"I don't think we will see eradication for generations," said Rusen.
The better understanding predicted by Sprigge is here, but the problem is a lack of investment into diagnostic tools and treatments as well as persisting poverty, he said.
There is still no test that can instantly determine if a person has TB and treatment requires a cocktail of drugs daily for at least six months, a length of time to which few patients can adhere.
"There hasn't been the resources put into tuberculosis as there has been in other diseases," Rusen said.
"One can argue that it's because tuberculosis mainly affects poor people and mainly affects countries that are far removed from us."
Poverty breeds TB, which helps to explain why First Nations communities see higher rates, according to Health Canada and Rusen.
"The challenge is that TB is still so linked with socio-economic status and conditions of poverty," Rusen said.
"In a country like Canada, while we may be better off and have addressed the underlying socio-economic conditions for the majority of people, we haven't done it universally. Until we address those underlying issues it will be difficult to address the disease itself."
There is light at the end of the tunnel however, said Rusen.
A new test that can be done on the spot is in the works and countries have renewed funding commitments for the fight against global tuberculosis, including Canada, which invested $140 million in 2010.
Data from the World Health Organization also shows that TB rates globally peaked in 2004, although the total number of TB patients continues to increase with population growth.
http://www.montrealgazette.com/health/generations+from+eradication/4043573/story.html#ixzz1A1Xu8184