Global TB Fight Hits a Wall

Geeta Anand, Wall Street Journal, February 15, 2013

Here on center stage in the global crisis of drug-resistant tuberculosis, top doctors are sounding a new alarm: India’s emergency strategy to defeat the disease may be having the opposite effect—encouraging TB instead to mutate into more deadly and unstoppable strains.

In its new strategy, India is treating some, and perhaps many, drug-resistant TB patients with drugs that they are already resistant to. That can allow the bacteria to build resistance to new drugs as well.

On Friday, a prominent specialist described research to The Wall Street Journal showing that the government’s treatment plan wouldn’t work on fully two-thirds of the 300 patients analyzed at one major Mumbai hospital. The results suggest India’s plan is “a futile exercise” that will “serve to amplify resistance,” said the researcher, Dr. Zarir Udwadia. “It is morally and medically disastrous.”

Shown the findings, Mario Raviglione, director of the World Health Organization’s Stop TB Department, called India’s approach to treating drug-resistant TB “complete nonsense.”

Ashok Kumar, head of the Central TB Division of India’s health ministry, declined several requests for comment.

India estimates it is home to 100,000 patients with drug-resistant TB—the most in the world—but for years it officially ignored them in favor of treating traditional TB, which is more common and curable. That policy left drug-resistant strains to spread and worsen. For countless thousands of people, it amounted to a death sentence.

Last year New Delhi made a historic policy reversal, scaling up a new strategy for treating drug-resistant patients. The change followed a Journal investigation in 2012 revealing that India, for years, had ignored evidence of increasing drug resistance and today likely has far higher rates of resistant TB than officially reported. The Journal also showed that the WHO’s own policies inadvertently helped drug-resistant TB to flourish.

Drug-resistant strains are edging up in the U.S. and increasing in parts of Europe, though most cases are in India, China and Russia, the WHO says. In some Indian patients, TB is now all but incurable.

{snip}

The issue with India’s new program, doctors say, is that tries to be one-size-fits-all: The same six-drug cocktail is given to every drug-resistant patient, without thorough testing to see which they are resistant to.

Experts say at least four of the six drugs must work for most patients to be cured.

{snip}

The WHO’s Dr. Raviglione said, “It is silly to use drugs that there is proven high resistance to, thinking they will work.” The WHO recommends testing patients for drug resistance. If there aren’t enough labs to do that, he said, Mumbai should conduct surveys to see which drugs its patients are most resistant to, then replace those drugs in the standard cocktail.

{snip}

The world is battling an epidemic of drug-resistant TB. India has about 2.2 million of the estimated 8.7 million total TB patients world-wide, the most of any country. Last year it said it would scale up its treatment of drug-resistant TB and eventually test all TB patients for resistance at their initial diagnosis.

Several studies suggest substantial resistance here in Mumbai to many drugs in the government’s treatment regimen. A preliminary analysis of one study under way showed that 28% of all TB patients tested in Mumbai were drug-resistant.

{snip}

One basic problem: India doesn’t have enough labs to test every patient for resistance, and likely won’t for years. {snip}

{snip}

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  • The__Bobster

    Naturally, libtarded do-gooders will want to import these infected people.

    • jambi19

      There is a good chance your Indian Doctor in the future will have moved here having already been infected as a carrier. You know, to “do a job Americans won’t do.”

      • The Worlds Scapegoat

        “do a job Americans won’t do.”

        Discriminate against whites for 1/10 the wages?

    • dd121

      To continue your thought “…these infected people first, so they can receive the best medical care at a publicly funded research institution”.

      • jambi19

        It’s actually an amazing phenomenon in the medical community that young and middle age white healthcare professionals go to third world countries in order to volunteer medical services. It is a big ego booster to the northeastern white liberals. Medical admission directors to schools in the USA screen for these medical mission trips during the application process viewing the experiences as resume enhancers. What makes this situation so amazing is that healthcare professionals/students from third world countries who immigrate here to practice professionally are particularly absent from these medical mission trips. You would think they would help out their vibrant and diverse countries of origin. They must be too busy “doing the jobs Americans won’t do.”

    • Guest

      It’s actually an amazing phenomenon in the medical community that young and middle age white healthcare professionals go to third world countries in order to volunteer medical services. It is a big ego booster to the northeastern white liberals. Medical applications to schools in the USA screen for these medical mission trips during the admission process viewing the experiences as resume enhancers. What makes this situation so amazing is that healthcare professionals from third world countries who immigrate here to practice professionally are particularly absent from these medical mission trips. They must be too busy “doing the jobs Americans won’t do.”

  • potato78

    Number one priority India government needs to do is to make their country more sanitary!

    the opposite effect—encouraging TB instead to mutate into more deadly and unstoppable strains.

    Sincere suggestion for my black “Aryan” brothers.

    http://theplanetd.com/india-is-filthy/
    http://answers.yahoo.com/question/index?qid=20120901134630AA86N8T

    • GM (Australia)

      1, Sanitary, do they know the meaning of the word? Even when they come here they have little idea of personal hygiene. I understand that some Indian women NEVER have a bath or shower in their whole lifetime, their religious beliefs do not allow it.

      2, Bathing in the Ganges River, done for religious purification etc. The Ganges is little better than an open sewer except it has corpses in it also.

      3, J & J were importing dressings and other first aid supplies from India at one stage, they were all contaminated.

  • bigone4u

    Jeez, one more thing to worry about because of the open borders agenda foisted off on us by the federal government. Immigration has the potential to be the death of us all, which is one more reason to repeal the laws allowing immigration. I doubt that even if millions were dying in America from diseases imported from India that Obummer would use his executive power to quarantine Indians. Political correctness trumps all, including life.

    • jambi19

      Just remember this when the next arrogant liberal rebuffs your concerns as “irrational fear”: public school history indoctrination hammers home the theory that whites immigrated to America and killed all the native americans with incurable disease. It is a complete lie based on fallacies of logic, reason and understanding. Yet the theory that whites gave native americans small pox blankets in order to genocide them is dogma in university history academia. I wouldn’t expect any liberal you encounter to understand the connection I just made. Like you stated, “political correctness trumps all, including life (reality)” to the weak minded liberal conformists.

      • bigone4u

        Right you are. If Euros genocided the Indians, we did a poor job given how many of them are still around.

      • The Last White Man Standing

        Scum sucking liberals never mention how the Indians gave us the gift of tobacco. Smoking is a leading cause of many of the illnesses which plague us today.

        • Katherine McChesney

          .

        • Michael_C_Scott

          Wrong Indians.

  • IstvanIN

    I thought Indians were so smart and that is why we need more H1B visa types here in the US?

  • Drug resistant diseases …. the contributions of the third world to the first world.

    • jambi19

      Record this next to nuclear arm proliferation, nigerian email scams, and excessive environmental deprivation as results of what happens when first world science/technology is handed to third world peoples.

      • jambi19

        Sorry I almost forgot to blame these potential mega disasters on “white privilege”, “the legacy of colonialism”, and my new favorite “western prejudices of beauty and worth.” (Sarcasm)

  • Katherine McChesney

    I googled India. PEEE-you. It’s filthy. Why would anyone want to mix with these people? India looks like the garbage can of the world.

  • HadEnough

    Have no fear, David Cameron is here — in this case with a newly minted promise of unlimited and permanent student immigration to Britain from India. Yippee, more unemployment for Whitey AND a new incurable pandemic. You just can’t make this stuff up!

    • IstvanIN

      TB won’t wipe out 1.2 billion Indians, there are just too many, but Cameron could get his wish and wipe out a mere 50 million native British by importing TB infected Indians.

    • Temp8

      According to people like you, making stuff up is possible. Do you even know the kind of preliminary and mandatory health checks required to even apply for a tourist visa to other nations (U.S., U.K. etc.)? Imagine how hard the tests are, to just be eligible for employment visas? I know because, I once toured the U.S. and the kind of procedures, man, it’s tiring.

  • 3rdWorldThinkin

    “India estimates it is home to 100,000 patients with drug-resistant
    TB
    —the most in the world—but for years it officially ignored them…”

    It seemed like a good idea, at the time.

  • LHathaway

    “whites gave native americans small pox blankets in order to genocide them is dogma in university history academia”

    Actually, western medicine eradicated smallpox. Ever since, social scientist have been saying whites eradicated non-whites with smallpox. I don’t believe this ‘fact’ appeared in any history book Before vaccination eradicated smallpox. Some elite somewhere, who probably defies the term ‘liberal’ must have thought that since we’re reversing or ‘inverting’ everything else that is true in the world, we might as well reverse this too.

    Perhaps the idea that western medicine eradicated smallpox was thought to be ‘bad for the self-esteem’ of some of us. Those that appear to count as people, apparently.

    Many of the liberal elites who are the very smartest see what is being done and then follow along or even copy this behavior. They must add to the learning by doing their own part to enlightening us with ‘science’ and ‘history’.

  • KenelmDigby

    UK PM David Cameron announced the other day that he will abolish immigration controls for Indians.

  • Felix_M

    Yup, and we have no problem with letting these clowns into the country without a health screening. Incredible.

    When the revolution comes I hope our congressmen and other “leaders” who failed to protect us are the first up against the wall.

  • Felix_M

    Google “cysticercosis.”

    It’s the leading cause of seizures in Latin America and is on the upswing in this country. (Guess why?) Because you can get it from someone who hasn’t washed his/her hands after using the bathroom, the next time you dine out, think carefully about who’s preparing your salad.

  • Morris Thecat

    gubbb’mint run health care folks

  • Shattered

    Never expect first-world results from the third world.

  • freddy_hills

    I’ve never been to India but I’ve liked most of the ones I’ve known. I’m sure that with 1.2 billion people most of whom live in poverty that you have bot extremes — those who are extremely kind and those who are extremely unkind. So let’s stick to the topic.

    Abusing anti-biotics is a huge problem for everyone. The WHO needs to establish some guidelines with teeth to ensure these drug-resistant strains don’t get out of hand. I would recommend extensive vaccination and screenings. Those with curable forms should be forced to complete the full course of treatment. Those who fail to do so or have incurable forms should be confined to sanitariums.

    • Michael_C_Scott

      I originally liked the Hindus at work in 1996, but it just didn’t work out. They eventually hated me for my rapport with the Japanese engineers. I took the trouble to learn Japanese, and drove them and their wives to go shooting on weekends. Hindustanis are – in my experience – backstabbers.

      I was loaned to a Japanese chemical company in 1994, and they were as kind as could be.

      I once overheard a conversation at work about why Japanese liked me so much, between a Mozambique Portugese gal and the other whites. Originally, I detested Japanese, but they “grew on me”, I suspect. I learned their language and had them over for dinner (my chile rellenos are famous) and worked on their cars.

      I think subcontinental Indians are arrogant and stupid even when they aren’t deliberately evil and/or Muslim.

  • SintiriNikos

    As if I needed another reason to never visit India…but keep ’em comin’