TB background document: New Faces of an Old Disease

Many people in rich countries think of tuberculosis as a disease of the past. Indeed well into the 1980s, experts thought that tuberculosis (TB) could be eliminated in a matter of decades. TB was seemingly under control.

Antibiotics, developed from the 1940s on, appeared to be effective in treating the disease. And as long as the strategy introduced by the World Health Organization (WHO), known as DOTS (Directly Observed Treatment, Short-Course), was correctly and efficiently rolled out, policy makers were convinced that TB would one day be a scourge of the past.

But now the international community recognises that with around nine million new cases appearing every year, TB is far from defeated. TB is a deadly killer, responsible for 1.7 million deaths in 2006 – that is almost four lives claimed every single minute. The vast majority of TB cases occur in developing countries, with 22 high burden countries (mostly low and middle income countries) carrying approximately 80 percent of the global burden. Two billion people – one third of the world’s population – are infected and carry the tubercle bacillus.

Worse, this ‘disease of the past’ has returned with new faces that are stretching our capacities to breaking point. The rapid spread of TB among people living with HIV, coupled with the emergence and spread of strains of TB that are resistant to the most common and effective drugs used to treat the disease, have led to a situation where far from being contained, TB is in fact spiralling out of control. After calling victory too early, the world is waking up to the fact that TB has re-emerged as a major threat to global health.