It’s been nearly a decade since U2 frontman Bono turned the entire continent of Africa into a pet cause, drawing attention to the problems of -developing-world health like never before. By some accounts, that publicity has started to pay off: since 2000, malaria incidence is down 50 percent in some of the hardest-hit regions, and in the past five years, the number of people with access to life-saving HIV medications has increased 10-fold. But while First World philanthropists and rock-star do-gooders were out to conquer AIDS and malaria, they left a far more ancient killer to fester. Tuberculosis has been traced back as far as the Egyptian mummies. It still kills 5,000 people every day—more people than swine flu has killed in the past year. And right now, natural selection and human fallibility are conspiring to make the germ indestructible.
Since the first effective medications were made available in 1944, Mycobacterium tuberculosis has routinely developed resistance to one drug after another. But in the late 1990s a more disturbing trend emerged: strains of tuberculosis called multidrug-resistant, or MDR-TB, that were resistant to not one but several of the most effective medications (called first-line drugs), began popping up in Africa, Asia, and Eastern Europe. Now those strains have evolved into something even more deadly: extensively drug-resistant, or XDR-TB, which is impervious to first-, second-, and third-line drugs—virtually all the antibiotics in existence. It’s the kind of bug that gives epidemiologists nightmares. And in the past two years, while the world was distracted by the financial crisis, it has emerged in nearly every country on the planet. Experts say it’s time to start worrying. In a 2009 speech delivered to the U.N., World Health Organization director Margaret Chan warned that without swift, decisive action, we might soon find ourselves back in “an era that predates the development of antibiotics,” when tuberculosis was completely incurable. In country after country, drug-resistant strains will start to replace drug-susceptible strains, spreading from the inner cities to the suburbs and from the slums to the countryside. And as scientists start from scratch in a hunt for effective antibiotics, the death toll will steadily rise in rich countries as well as poor. (more…)