Fighting Tuberculosis
Tuberculosis is the leading cause of death due to disease. It is estimated that 1.8 Billion people have the bacteria that causes the disease, Mycobacterium tuberculosis, and 10 million people became ill with the disease in 2017 according to the World Health Organization. It is spread by saliva droplets that are coughed or sneezed out. Around the end of the 19th century and the beginning of the 20th century, New York experienced an influx of immigrants and an outbreak of TB. The people who were afflicted by the disease were people who lived in small apartments that had poor circulation and tenements with mud floors that made it very hard to clean. This meant that it was mostly the poor immigrants who found living in tenements particularly susceptible to the disease. Living conditions like these greatly contributed to the spread of TB because of how the disease is transmitted. Robert Koch discovered that the bacteria that causes the disease can survive in saliva for a day and that it could spread through coughing and sneezing. Those who are impoverished are also much more likely to contract the disease because malnutrition weakens the immune system and they don’t have enough money to pay for better living conditions. There quickly became a social stigma that made having TB a sign of being poor and this led people to refuse to admit that they had the disease. According to the World Health Organization, around 11% of the people with TB also have HIV. It is also estimated that people with HIV are 16-27 times more likely to get TB. This has also contributed to the stigma of having TB. Sadly, the negative stigma is so strong, many people refuse treatment.
The treatment of TB is long and grueling. An infected individual will have to take a literal handful of drugs multiple times a day as well as receiving an injection. If your case of TB is worse, you will have to live in a hospital/care facility that removes you from your life for a period of time lasting for 6 months up to 2 years. This only adds to the difficulty of dealing with TB. The struggle people have going through the treatment is bad enough that less than half of those undergoing treatment actually complete it. Compounding this issue are the side effects of TB. Not only do you have to feel the pain of receiving a shot every day and taking many pills, you will likely vomit and feel ill. This is what causes so many people to take their pills and stick with their treatment. The patients have to choose between making themselves feel sick and struggling with the treatment or dying of TB, neither of which are good options. To make matters even more harsh, there are two strains of TB that are harder to treat, Multidrug-Resistant TB and Extensively Drug-Resistant TB. MDR TB is caused by bacteria that are resistant to isoniazid and rifampin, which are used to treat all patients with TB. XDR TB is caused by bacteria that are resistant to isoniazid, rifampin, any fluoroquinolone and one of the three injectable second-line drugs. These strains of Mycobacterium tuberculosis are relatively less common than normal strains of TB, but they are much harder to treat because the take drugs that are less effective.
In recent history, diseases like Smallpox have been totally or nearly eradicated. TB should be the next on the list of diseases to be eradicated. To do this, many challenges have to be overcome. First of which is the sheer number of people with the disease. According to the World Health Organization, 1.8 billion people have Mycobacterium tuberculosis in them and as many as 10 million people became ill from the bacteria. Any effort to eradicate the disease will have to conquer the vast number of people who are susceptible to become sick. Another issue is the treatment of the disease. The current method for treating people is relatively ineffective. It is not good enough that only half of the people who start treatment finish it. In order to eradicate the disease, nearly everyone will need to be fully treated to prevent anyone else from contracting the disease. The problems with the current treatment are that it takes a long time, it causes the patient to suffer and it removes them from their life. New drugs that don’t have such punishing side effects or treat the disease faster would be a dramatic help. Further issues surrounding the eradication of TB include the social stigma and the surveillance of the disease. Due to the stigma, many people don’t want to admit they have the disease. This makes it hard to know how many really have the disease and prevents a lot of people from reaching out and trying to find treatment. One of the most important steps in eradicating TB would be to work on removing the social stigma and encouraging people to seek help. Surveilling the disease is absolutely crucial as well. If we do not find everyone infected with the bacteria, we will not eradicate the disease. These challenges are overwhelming and there is no doubt that a large international effort would be required if there is any hope of eradicating the disease.
All information is gathered from the sources on canvas and the World Health Organization