Global Public Health Threats

6. Why is drug-resistant tuberculosis a growing public health concern?

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 by drug-resistant 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 countries.

An additional complication comes from the combination of drug-resistant tuberculosis 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 tuberculosis, unless 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 multi-drug resistant tuberculosis have to be dealt with quickly, strongly and urgently, at both national and international levels.

To prepare for outbreaks of drug-resistant tuberculosis laboratories 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: WHO, World Health Report 2007 – A safer future: global public health security in the 21^st century (2007),
Chapter 4: Learning lessons, thinking ahead, "Extensively drug-resistant tuberculosis", p.52-53