5 ms·

The news about better treatment for drug-resistant tuberculosis is huge. If confirmed, that'll be the basis for saving many lives in the next decade, especially

The news about better treatment for drug-resistant tuberculosis is huge. If confirmed, that'll be the basis for saving many lives in the next decade, especially in India. Multiple-drug-resistant tuberculosis has been an alarming problem there.[1] [1] http://articles.economictimes.indiatimes.com/2013-06-23/news/40134749_1_stop-tb-department-mario-raviglione-jmm-meeting http://articles.economictimes.indiatimes.com/2013-06-23/news... http://www.wsj.com/news/articles/SB10001424052702303444204577460734274201756/ http://www.wsj.com/news/articles/SB1000142405270230344420457... http://www.iom.edu/Reports/2012/Facing-the-Reality-of-Drug-Resistant-Tuberculosis-Challenges-and-Potential-Solutions-in-India.aspx/ http://www.iom.edu/Reports/2012/Facing-the-Reality-of-Drug-R...

jsankey 12y ago
Agreed. Living in the age of antibiotics we (in the developed world) have quickly forgotten how deadly TB is (it was a leading cause of death just 100 years ago). Given the difficulty in developing new antibiotics (and relative lack of commercial incentive to do so) the news that they've found a more effective new drug combination (including new drugs) is very welcome. The fact that the regimen is shorter will hopefully mean higher completion rates: a big issue at the moment as the treatment can take up to 2 years leading many patients to take incomplete courses (and of course this fuels drug resistance). In Australia we're lucky enough to have the resources to provide free treatment with mandatory monitoring by health care workers (to enforce the full course is taken), but in India, PNG etc they desperately need a cheaper and more practical solution. Edit to add: hopefully new drugs will also help those with sensitivity to the current antibiotics. They have some pretty harsh side effects, e.g. drug-induced hepatitis is a common problem which means many patients can't tolerate the preferred regimen.
melling 12y ago
Isn't the problem of drug resistance made-made? http://www.who.int/tb/challenges/mdr/en/ http://www.who.int/tb/challenges/mdr/en/ In India, in particular, anyone can buy antibiotics, and they do, whether they need them or not. This problem should probably be addressed before we create a problem that we can't solve.
- jared314 12y ago
  > This problem should probably be addressed before we create a problem that we can't solve. That still leaves the nasty issue of what to do with the large number of people who have contracted a highly contagious and drug-resistant / incurable disease.
- jsankey 12y ago
  Yes, the problem is man made, but not only due to unofficial access to antibiotics. I suspect that's not even a major factor, but correct me if I've missed something. As discussed: TB currently takes a long time to fully treat. A lot of patients can't afford a full course of the recommended combination of drugs. Even if they can, and are getting their drugs from official channels, they need to be monitored regularly (sometimes daily) to ensure proper treatment. The resources to do this monitoring simply don't exist in India (and many other countries). Thus, even if you could stop all unofficial access to antibiotics (impossible in practice), there is simply not enough funding to ensure every patient is properly treated. This is why a shorter regimen is a key breakthrough. It makes proper treatment much more accessible (the big issue), while also reducing the discipline needed to complete a course (a small bonus).
- IndianAstronaut 12y ago
  The drug resistant tuberculosis is already here so we have to solve it. But to prevent future problems, people need to stop using antibiotics as a cure all. It is particularly bad in India since patients there can aggressively demand antibiotics from hospitals and doctors.
wahsd 12y ago
Serious question though, and I would like people to ignore some sort of moral or religious argument for it; but what is the long term implication if all kinds of health advances save people but humans still reproduce and impact the planet in already unsustainable rates. I get it, some people have a bleeding heart and want to save everyone, everywhere, at all times; but what happens when the planet is the equivalent of a cat hoarder's house because we could never say no and we could never implement policy to limit population growth because the wealthy inherently gain from unregulated population growth?
- octaveguin 12y ago
  Gates actually addressed this[0]. The upshot is that as countries get richer, fertility rates decrease. Allowing these poorer countries to lead better lives will paradoxically lower the population increase. If you look at the western world, negating immigration, many countries have a shrinking population. The more pressing problem of the future, ironically, will be under population - at least if you consider the economic impact and our way of life. Our economy right now is built on so much growth and young labor. What happens without poor countries and when more people are retired than working? [0]http://annualletter.gatesfoundation.org/#myth-three=&section=myth-three http://annualletter.gatesfoundation.org/#myth-three=&section...
  - TillE 12y ago
    > If you look at the western world, negating immigration, many countries have a shrinking population. Even with immigration, Germany has a slightly negative population growth rate. And the United States grew by only 0.77% in a year. Again, that's with immigration. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2002rank.html https://www.cia.gov/library/publications/the-world-factbook/... There's a conversation to be had about the future of non-renewable resources and the preservation of renewable ones, but the population growth fear-mongering from the likes of Dan Brown is deeply silly and not based on the whole truth.
  - noobermin 12y ago
    Perhaps if this coincides with the rise of the machine replacing cheap labor, this might actually be a good thing, but something like a BIG would be needed to supply the non-working with income.

jsankey 12y ago

Agreed. Living in the age of antibiotics we (in the developed world) have quickly forgotten how deadly TB is (it was a leading cause of death just 100 years ago). Given the difficulty in developing new antibiotics (and relative lack of commercial incentive to do so) the news that they've found a more effective new drug combination (including new drugs) is very welcome. The fact that the regimen is shorter will hopefully mean higher completion rates: a big issue at the moment as the treatment can take up to 2 years leading many patients to take incomplete courses (and of course this fuels drug resistance). In Australia we're lucky enough to have the resources to provide free treatment with mandatory monitoring by health care workers (to enforce the full course is taken), but in India, PNG etc they desperately need a cheaper and more practical solution. Edit to add: hopefully new drugs will also help those with sensitivity to the current antibiotics. They have some pretty harsh side effects, e.g. drug-induced hepatitis is a common problem which means many patients can't tolerate the preferred regimen.

melling 12y ago

Isn't the problem of drug resistance made-made? http://www.who.int/tb/challenges/mdr/en/ http://www.who.int/tb/challenges/mdr/en/ In India, in particular, anyone can buy antibiotics, and they do, whether they need them or not. This problem should probably be addressed before we create a problem that we can't solve.

jared314 12y ago
> This problem should probably be addressed before we create a problem that we can't solve. That still leaves the nasty issue of what to do with the large number of people who have contracted a highly contagious and drug-resistant / incurable disease.
jsankey 12y ago
Yes, the problem is man made, but not only due to unofficial access to antibiotics. I suspect that's not even a major factor, but correct me if I've missed something. As discussed: TB currently takes a long time to fully treat. A lot of patients can't afford a full course of the recommended combination of drugs. Even if they can, and are getting their drugs from official channels, they need to be monitored regularly (sometimes daily) to ensure proper treatment. The resources to do this monitoring simply don't exist in India (and many other countries). Thus, even if you could stop all unofficial access to antibiotics (impossible in practice), there is simply not enough funding to ensure every patient is properly treated. This is why a shorter regimen is a key breakthrough. It makes proper treatment much more accessible (the big issue), while also reducing the discipline needed to complete a course (a small bonus).
IndianAstronaut 12y ago
The drug resistant tuberculosis is already here so we have to solve it. But to prevent future problems, people need to stop using antibiotics as a cure all. It is particularly bad in India since patients there can aggressively demand antibiotics from hospitals and doctors.

wahsd 12y ago

Serious question though, and I would like people to ignore some sort of moral or religious argument for it; but what is the long term implication if all kinds of health advances save people but humans still reproduce and impact the planet in already unsustainable rates. I get it, some people have a bleeding heart and want to save everyone, everywhere, at all times; but what happens when the planet is the equivalent of a cat hoarder's house because we could never say no and we could never implement policy to limit population growth because the wealthy inherently gain from unregulated population growth?

octaveguin 12y ago
Gates actually addressed this[0]. The upshot is that as countries get richer, fertility rates decrease. Allowing these poorer countries to lead better lives will paradoxically lower the population increase. If you look at the western world, negating immigration, many countries have a shrinking population. The more pressing problem of the future, ironically, will be under population - at least if you consider the economic impact and our way of life. Our economy right now is built on so much growth and young labor. What happens without poor countries and when more people are retired than working? [0]http://annualletter.gatesfoundation.org/#myth-three=&section=myth-three http://annualletter.gatesfoundation.org/#myth-three=&section...
- TillE 12y ago
  > If you look at the western world, negating immigration, many countries have a shrinking population. Even with immigration, Germany has a slightly negative population growth rate. And the United States grew by only 0.77% in a year. Again, that's with immigration. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2002rank.html https://www.cia.gov/library/publications/the-world-factbook/... There's a conversation to be had about the future of non-renewable resources and the preservation of renewable ones, but the population growth fear-mongering from the likes of Dan Brown is deeply silly and not based on the whole truth.
- noobermin 12y ago
  Perhaps if this coincides with the rise of the machine replacing cheap labor, this might actually be a good thing, but something like a BIG would be needed to supply the non-working with income.