The Return of TB

Richard J B Willis

BUC Health Ministries Director

TB – two letters that sent shivers down the spines of our Victorian and post-Victorian ancestors. No respecter of persons, TB claimed the lives of millions and became the subject matter of many of the novels and plays centred in the era. Then TB disappeared as new wonder-drugs were used to rid the country of the scourge. So confident were they that this disease, tuberculosis, had been eradicated that even the sanitoria and isolation hospitals used to treat TB patients were closed or pulled down by the health authorities. It is said that 'what goes round, comes round' and that is what has happened with TB. One person is infected with TB every 4 seconds and one person dies of the disease every 10 seconds somewhere in the world. London alone had around 1500 TB cases in 1988 and this has doubled to-date and is more than 50 per cent higher than New York city.

TB claims 2 to 3 million lives a year world-wide and currently affects approximately 2 billion people and is often found in company with HIV/AIDS due to the same environmental conditions which favour the spread of disease. It is not necessary to go to developing nations to find these conditions. Newham, in London, has a prevalence of 108 cases per 100,000 in the community which puts TB in a league of its own if you compare the prevalence with India at 41 per 100,000 or even Russia at 91 per 100,000.

The original wonder-pills have passed into history, with the exception of para-amino salicylic acid (PAS), and new drugs such as capreomycin, cycloserine, ofloxacin and ciprofloxacin have taken their place. It is hoped that these drugs will be produced cheaply to stop the epidemics that ravage different parts of the world, and that new and more effective drugs might be found to counteract the 1.5 per cent of TB which is multi-drug resistant. Unfortunately drug resistant strains of TB are found where the disease can spread quickly such as in the former Soviet Union.

Whilst the cost of treating regular TB is only a few pounds for the entire course of medication, treating resistant strains of TB push the cost up to about £3,000 thus taking the therapy beyond the means of many governments and individuals. Daily some 3,000 Londoners are taking their range of medication and at a varied cost.

Not that it is any excuse but TB is not 'home-grown'. Areas such as Newham have become the centres for many refugees and immigrants seeking a home in the UK and they have brought the TB with them from their point of origin. Wherever the disease is to be found there is a great need for us to play our part in eliminating the conditions under which the disease thrives and care for the people concerned.

© The Stanborough Press