We have posted about the Tuberculosis risks previously: Extensively Drug-resistant Tuberculosis (XDR TB), May 2007 – Deadly TB Strain is Spreading, WHO Warns, Mar 2007 – Tuberculosis Pandemic Threat, Jan 2007 – ‘Virtually untreatable’ TB found, Sep 2006. One USA citizen, while infected with XDR TB, flying to Europe and then to Canada and driving back into the USA has created a huge amount of publicity on this topic in the last week.
The risks are well known, given the extreme mobility in the world today, for TB, and other communicable diseases, becoming more troublesome, costly and deadly – often due to improper antibiotic use. But we continue to avoid giving this risk near the level of attention it seems to deserve. Deaths due to these diseases is likely to be very high in the next 20 years.
In fact there were 1.6 million TB deaths in 2005 (see WHO fact sheet below). Even if you only care about deaths in the USA (I am not advocating such a position, but even for those that hold such a position…) failing to address these issues will greatly increase the odds of large numbers of deaths in the USA (for TB and other diseases that become difficult or impossible to treat with antibiotics).
The current news will do little in my opinion (though it will help raise awareness). It will take a significant number of deaths in the USA, for significant policy changes to be implemented. Luckily scientists and policy makers have been giving these risks thought and so possible actions are already fairly well know. Unfortunately we seem very inclined to ignore problems for those out of sight (either continents away, or in the future) so until the consequences of the current action forces people to confront this issue little has been done (well actually good action is being taken, but much more is left to do).
One huge issue is quarantine. Personally, I try to use as a guide that people have the right to do what doesn’t infringe upon others rights. This allows plenty of room for debate about what level of trade-off is acceptable but I find it a useful guide to shape my thoughts. People don’t have the right to drive drunk and endanger others. People don’t have the right to pollute the air of others by smoking (or polluting the air with dangerous chemicals, CO2…). People don’t have the right to expose others to dangerous communicable diseases. Doctor’s don’t have the right to proscribe antibiotics when not medically justified (creating risks to those in the future)… But how society decides to define the social contract that everyone must agree to (rather that a way I find useful to help me analyze what is reasonable) is in need of some increased clarity in the light of health care issues today.
World Health Organization fact sheet on Tuberculosis:
Continue reading →