'There is a real chance that tuberculosis will become untreatable in the near future.' It was with these ominous words that TV science programme Focus, aired by public broadcaster NTR on NPO2 on 24 October (watch it here (Dutch)), sounded the alarm about the problem of the world's deadliest bug.
The programme's message was that in theory, we all could get infected. The presenters show that although the disease is treatable, such treatment is heavy, lengthy and extremely taxing – not only for patients, but also for those around them.
Over 1.5 million fatalities a year
Tuberculosis (historically also known as consumption, today commonly shortened to TB), is a very serious disease. Those infected become gravely ill. Yet the Netherlands has kept TB under control for decades now thanks to a combination of diligent population screening and use of available antibiotics, limiting the number of new cases diagnosed each year to approximately 800 in our country. Worldwide, however, TB remains one of the deadliest infectious diseases around, claiming the lives of more than 1.5 million victims annually.
It is this number of worldwide infections, coupled with increased migration, that is feeding the ongoing risk of new TB outbreaks – in the Netherlands, too. What is more, a growing number of strains of the disease are proving resistant to existing antibiotics. These antibiotics, requiring dosages as high as ten tablets a day, are in themselves extremely taxing on the body, with nasty side effects ranging from nausea to permanent liver damage and hearing loss.
Scientific quest for better treatment results
Whereas Dutch health workers are focusing their efforts on careful population monitoring and patient assistance, scientists are doubling down on faster diagnostics and improved treatment of TB. For instance, they're working hard to develop practical DNA-sequencing devices that can be used to detect TB and/or antibiotic resistance within mere hours instead of weeks. Scientists are also applying new algorithms to test the potential of existing medications for other diseases – which are therefore already available – looking in particular at whether these agents (medicines) may also be able to strengthen our natural immune response to TB. While this line of treatment, known as host-directed therapy, or HDT, would not replace antibiotics, hopes are the two could be combined to ramp up treatment results.
Today, with TB claiming more victims than even HIV/AIDS, it is cause for concern that research funding for TB is disproportionately less than spending on infectious diseases deemed to pose a lesser threat. As the recent episode of Focus made clear, if we are to avoid losing this ongoing battle, we must invest in sustained research into the treatment of TB.