6. Why is drug-resistant tuberculosis a growing public health concern?
Affected patients can be unresponsive to one or several
Source: Adam Ciesielski
The emergence of drug-resistant
tuberculosis is a man-made
problem caused by inadequate health systems that do not treat
tuberculosis cases promptly enough and which do not ensure that
patients follow the entire treatment.
Beyond the immediate consequences to the individuals affected
tuberculosis, the global
public health concern is that drug-resistant tuberculosis seems
to be as transmissible as the treatable forms of the disease. As
of 1 May 2007, the most dangerous of all forms of drug-resistant
tuberculosis has been confirmed in 37 countries, not only in the
developing world but also in wealthy countries, including all G8
An additional complication comes from the combination of
with HIV. In the presence of HIV, tuberculosis that is not
treated properly, will cause death within weeks.
Patients attending clinics to obtain HIV treatment with
antiretroviral drugs are at
particular risk of catching
hospitals control the transmission of airborne infections.
Health-care workers who are in close
contact with patients and do not tell their supervisors that
they are infected by HIV,
may also be putting their own lives at increased risk.
It is very important that all
tuberculosis infections are
identified and treated promptly, and that patients take all the
drugs they have been prescribed. Drugs used to control
infections have to be used appropriately to avoid the emergence
of forms of tuberculosis that are resistant to more than one
drug at the same time. The existing cases of
tuberculosis have to be dealt with quickly, strongly and
urgently, at both national and international levels.
To prepare for outbreaks of drug-resistant
and staff that can diagnose the disease are needed and there
must be a supply of the necessary high-quality drugs. It is also
essential to monitor the spread of drug-resistant tuberculosis
to inform the public and health-care staff.
This text is a summary of:
World Health Report 2007 – A safer future: global public health
security in the 21st century (2007),
Chapter 4: Learning lessons, thinking ahead, "Extensively drug-resistant tuberculosis", p.52-53