Co-authored by Vince Forlenza, president and COO of Becton, Dickinson, and Company.
When Dr. Robert Koch discovered Mycobacterium tuberculosis in 1882, pulmonary tuberculosis killed two out of every three people it infected. If untreated, this highly transmissible respiratory infection -- known a century ago as consumption and today simply as TB -- colonizes the human lungs, slowly suffocating its host.
Koch's achievement led to a crude but effective TB diagnostic known as sputum microscopy. Potent medicines were eventually introduced and countless lives have been spared. But today, decades after the first robust TB treatment regimen was introduced, the disease is rebounding furiously. Progress against TB has steadily reversed around the world, and it remains one of the leading causes of death.
In 2009, TB killed an estimated 1.7 million people. Many didn't know they had it; hundreds of thousands had drug-resistant infection, which is difficult to detect accurately.
Sputum microscopy -- the simple but fallible process of collecting and examining respiratory fluid -- is still the diagnostic mainstay in many countries, but the method is a century old and largely ineffective.
The only way to halt TB's resurgence and eradicate it once and for all is to first improve our ability to detect it, prevent it and treat it. But before patients can be appropriately treated -- or treated at all -- they must be accurately diagnosed.
To diagnose patients with active TB who are in need of treatment more accurately and more quickly, complementary diagnostics are required. Two technologies that the World Health Organization has recently endorsed are liquid culture and molecular diagnostics. Together, these technologies offer exciting new possibilities for diagnosing drug-resistant TB. Increasing access to these technologies requires investment in improving the laboratory capacity of the developing world.
Equally fundamental to improving detection is improving access to equipment and expertise. Through smart public-private collaborations, developers provide their equipment to resource-limited settings through unique pricing agreements and provide technical assistance to strengthen fragile health systems.
In addition to improved diagnostics, the fight against TB also requires new drug therapies and vaccines. Organizations like the Aeras Global TB Vaccine Foundation and the Global Alliance for TB Drug Development are innovative, non-profit product development partnerships that are putting much needed new drugs and vaccines in the pipeline.
With technical cooperation like this, coupled with compassion and willpower, we can make TB a term as obsolete as the names that came before it.