Tuberculosis: A Continuing, Deadly Threat

December 31, 2001

New York, Jan. 1 – In his memoirs, Alexandre Dumas observed wryly that "it was all the fashion to suffer from chest complaint; everybody was consumptive, poets especially."

Consumption, as tuberculosis was known, may have made it "good form to spit blood," as the novelist observed, but the airborne disease is nothing to jest about: it will newly infect 8.4 million people this year and kill 2 million. Since its advent centuries ago, tuberculosis has taken more lives than any other single infection in history.

This chilling book, by the executive director of the New Jersey Medical School National Tuberculosis Center, warns that the ancient disease has not only survived but "once again, it has strayed far from the public mind in prosperous nations."

Fully a third of the world's population is infected with TB, Dr. Reichman says, a figure that includes at least 15 million Americans with a latent form of bacterium. "More people are dying of tuberculosis today than ever before in history," he adds. And years of neglect and mismanagement have allowed the creation of resistant strains of TB, which he describes as "curable only at enormous cost and effort when they can be cured at all."

Drug-resistant TB, he warns, could well become an untreatable epidemic. "We have no new diagnostic tests," he says, "no new drugs, no magic cures."

What is the world to do in the face of these grim predictions? One solution seems clear: getting pharmaceutical companies to overcome their reluctance to produce drugs for what he calls "unfashionable" and "third world" diseases that lack profitability. A new nonprofit Global Alliance for TB Drug Development is trying to convince drug makers that the TB market could be worth $700 million a year by 2010. The alliance plans to invest in promising antibiotics and give financial support to researchers and biotech companies.

Then there is education. "Give the future leaders of our society a healthy fear of TB and knowledge of how it can be controlled if and when there is political will," Dr. Reichman writes. "They will know that the knowledge and technology to eliminate TB exist."

"Timebomb: The Global Epidemic of Multi-Drug-Resistant Tuberculosis," by Dr. Lee B. Reichman with Janice Hopkins Tanne, McGraw-Hill, $24.95.