You probably haven’t heard much about tuberculosis, or TB. Maybe you remember that Nicole Kidman’s character Satine in Moulin Rouge died from TB. Or you remember Katerina Ivanova in Dostoevsky’s Crime and Punishment. But you probably don’t personally know anyone with the disease.
But the fact is, TB is everywhere. Epidemiologists estimate that 2.3 billion people in the world are infected with TB. Let that sink in for a minute. Two point three billion. Fully one-third of the world’s 7 billion population.
Why have you not heard much about it then? Well, because in the US, less than 1% of the population has been infected with TB.
The thing is, TB is a disease of the developing world. Every year, 9 million new people are diagnosed with TB disease – and 98% of them live in the developing world. Nelson Mandela said, “The world has made defeating AIDS a top priority. This is a blessing. But TB remains ignored. …We can’t fight AIDS unless we do much more to fight TB as well.”
In the emergency room in Ethiopia, I see TB every single day. Literally. Last week, I saw a woman come in with abdominal pain who had lost a fourth of her body weight. She looked like a skeleton. Her abdomen was rigid and tender, and it turned out she had TB infection of the intestines. Another day, I saw an adolescent with back pain because TB had destroyed his spine (we call this Pott’s disease).
This is the kind of stuff that you only read about in textbooks in America. But in Africa, it is deadly real. Ethiopia is one of the “high burden” countries for TB – 22 countries which make up 82% of the entire world’s cases . In Ethiopia, there are 280,000 new cases of TB diagnosed every year. Epidemiologists call this “incidence”. (By contrast, in the US, there are about 10,000 new cases of TB every year). The Millennium Development Goals are seeking to reduce TB in countries like Ethiopia. But the political will is lacking. There are few high profile celebrities with TB. Research dollars that go toward TB are dwarfed by that of HIV. Though we have countless new drugs for HIV, we have NO NEW DRUGS to treat TB.
What can we do to fight TB? For centuries, the only way to diagnose it has been by looking at someone’s sputum under a microscope. And this only catches TB 50% of the time! (In contrast, the test for HIV is in the blood, and is 99% accurate at detecting the disease). Finally, in recent years, a device has been developed that can confirm TB. It is called the GeneXpert, and we hope to get one here at Soddo Christian Hospital.
So today, on World TB Day, perhaps you find yourself asking, “What can I do to help stop TB?” Well, if you’re a friend of Soddo Christian Hospital, the answer is surprisingly simple. We would like to get a GeneXpert. It will make diagnosis of the disease more accurate, and allow us to help many more people. We will detect when patients are suffering from this horrible disease, and can start lifesaving therapies immediately.