Jamson Louis, 10, is showing improvement in his TB case in Mirebalais, Haiti. TB regularly mutates, resisting antibiotics developed to cure it.Credit Photo by Jon Lascher / Partners In Health

New York Times—Paul Farmer: Humans Aren’t Winning the War on TB

For decades there were few developments in the fight against tuberculosis — at least by humans. The bacteria that causes this airborne disease, in contrast, regularly boasts a number of deadly new upgrades, including mutations conferring resistance to almost all antibiotics developed to cure it. It has also made common cause with new allies (AIDS, weak health systems and budget cuts further sapping them) while maintaining its longstanding alliances with war, hunger, overcrowded and poorly ventilated housing, prisons, and workplaces.

One of TB’s lamentable champions is a common strain of public-health expertise, which has long lowballed what it takes to cure tuberculosis and halt transmission of increasingly resistant strains of it. A host of ill-conceived and unambitious policies have all but ignored TB’s innovations.

That’s why humans aren’t winning the war against TB, which last year killed 1.8 million people, regaining its old title as the world’s leading infectious killer of adults.
Happy World TB Day.

It gets worse, at least for the humans. Tuberculosis lost its world-killer title to AIDS at the new millennium. But the humans fought back hard against that virus and against attendant stigma, which was even worse than that reserved for TB. Ambitious programs like George W. Bush’s President’s Emergency Plan for AIDS Relief and a new agency called The Global Fund to Fight AIDS, Tuberculosis and Malaria sunk billions into AIDS treatment in Africa and the Caribbean. Leaders of such programs turned to experts for advice on the right therapies for drug-resistant tuberculosis. Long socialized for scarcity and lacking new tools to fight back, these experts squabbled about whether or not to even bother to treat it.

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