Abstract

PIP: Many people think of tuberculosis (TB) as a disease of the past of no current concern to modern society. This is not the case. Despite the medical establishment's ability to treat and cure TB, the disease has reemerged to assume the position as the leading killer worldwide among infectious or communicable diseases. TB threatens more people than AIDS, cholera, dengue fever, and other infectious diseases combined. Accordingly, the World Health Organization (WHO) declared a global state of emergency against TB in 1993. In 1993, 2.7 million people died from TB and another 8.1 million were infected. Worldwide, an estimated 1.7 billion people had inert TB infections. The current TB epidemic is expected to worsen, especially in the developing world due to the evolution of multi-drug-resistant strains and the emergence of AIDS which compromises human immune systems and makes them more susceptible to infectious diseases. By the year 2000, the global incidence of TB is expected to increase to 10.2 million cases per year, an increase of 36% over 1990's 7.5 million cases. 75% of the increase can be traced to poor TB control programs, population growth, and the advancing age of the population, while the remaining 25% is attributed to the interaction between the TB virus and HIV. More than 95% of TB cases reported in 1990 were in the developing world, with an estimated two thirds in Asia; India accounted for 2.1 million cases. Developing countries have a disproportionate number of cases because AIDS is spreading quickly, health services are inadequate, and little money is available for treatment. WHO points out that adherence to the complete and inexpensive drug regimen of rifampicin, isoniazid, pyrazinamide, and ethambutol every day for six to eight months could reduce the rate of TB transmission and cut the number of TB deaths in half over the next ten years. Worldwide early treatment could prevent almost 12 million deaths over the next decade and save large amounts of money. Moreover, global monitoring by WHO and regional health nongovernmental organizations to identify and diagnose TB must be combined with sufficient infrastructure and resources, such as vaccines, medicines, trained health personnel, and clinics. Funding for research and prevention and treatment programs is essential.