Dr. Sanjay Gupta, CNN Chief Medical Correspondent
(LIVE)
I'm Dr. Sanjay Gupta, and this is a special edition of HOUSECALL from Denver, Colorado. The medical story that got the most attention this week involves an Atlanta lawyer who traveled overseas infected with a deadly strain of tuberculosis. CNN's "Anderson Cooper 360" devoted a full hour last night to the topic. And we're bringing you the encore highlights of that show.
The fact that tuberculosis remains a global killer in the 21st century is more than sobering. It raises some tough questions. The bacteria that causes TB was identified 125 years ago. The first cure and antibiotic arrived in the 1940s. You would think that by now, medicine would have won the fight against this ancient disease, which by the way, has been around since the pharaohs. To understand why it hasn't, well, you need to follow the money.
CNN's Joe Johns is keeping them honest.
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JOE JOHNS, CNN CORRESPONDENT (voice-over): The most recent figures are alarming. In 2005, TB killed 1.6 million people around the world. But make no mistake, much is being done to fight the disease.
The problem is that currently, the best medicine available to treat it is a combination of four drugs that dates back more than four decades. That treatment remains effective, but -- and this is a big issue -- it's only reliable if patients follow it completely.
And that's really hard. Why? Because TB patients take the medication every day for months. And they must be carefully monitored. It's called directly observed treatment. That's why TB thrives in many developing countries, where there is a stigma attached to the disease, and where people living hand-to-mouth can't make the commitment of time and energy to go see a healthcare provider every day.
MARIA FREIRE, TB ALLIANCE: So you can imagine, for example, a woman that leaves her family every day to get the care she needs and then has to walk back to her home. And it becomes a very cumbersome thing for them to do. It's very difficult.
JOHNS: So why isn't there a vaccine or a more practical treatment that's easier and quicker for the patient and less hassle for the caregiver? Answer -- money.
NICOLE LURIE, DR., RAND CORP.: Because TB is a disease of poor people and people in developing countries, there haven't been really good incentives in the private sector to develop a vaccine, to develop new drugs, etcetera, and that also needs attention and a real boost.
JOHNS: In case you didn't get it, incentives means profits for drug companies.
Here's how the numbers work. The Global Alliance for TB Drug Development estimates global sales for first-line TB drugs at $315 million a year. By way of comparison, Viagra sales around the world raked in $1.7 billion last year. Plus, there are the costs of developing better TB drugs. The Global Alliance says it would take ten years and nearly $5 billion just to get them to market. So those numbers don't work for the drug companies. In other words, no money, no incentive to make a cure.
FRIERE: This market is not large enough for a big pharmaceutical company to enter with the idea of making money. So we have to find a way of lowering the hurdles for companies to invest.
JOHNS: But better treatment may come anyway, because with the currently available drugs and the ordeal of taking them daily and under supervision, people give up and don't follow through on the treatment.
MYLES DRUCKMAN, DR., INTERNATIONAL SOS: And if it's not treated effectively or inappropriately, you can get a lot of these diseases that are now drug resistant, which puts the whole, you know, globe at risk.
JOHNS: And that is what happened with Andrew Speaker. With air travel, a contagious disease can move around the world in a matter of hours.
Joe Johns, CNN, Washington.