Drug-Resistant 'White Plague' Lurks Among Rich and Poor

The World Health Organization met recently to discuss the possible emergence of tuberculosis that is resistant to all known medicines, or “totally drug-resistant” TB. If it is considered a new class definition, TDR TB would add a new category to TB’s evolution over the years from normal to multidrug-resistant (MDR), then extensively drug-resistant (XDR).

Lucica Ditiu of WHO’s Stop TB Partnership said all drug-resistant TB “is a totally man-made disease.” “It came about because patients were treated badly - either with poor quality drugs, or not enough drugs, or with insufficient observation so the patient didn’t finish the treatment course,” she said.

“Whether it’s MDR, XDR or TDR TB, it doesn’t make much difference to the patients,” said Ditiu. “A lot of them will face a very, very unfortunate fate.”

Rates of drug-resistant TB are rising rapidly in Asia, Africa, and in some of the world’s wealthiest cities, including London, now considered the “TB capital of Europe.”

In 2005, London lawyer-in-training Anna Watterson was diagnosed with MDR TB following months of treatment for regular TB. “My friends were really shocked,” Watterson said. “Most of them had only heard of TB from reading Victorian novels.”

At the time Watterson was living in the northwest borough of Brent, home to a large immigrant community and pockets of poverty. Like many in London, she commuted using the subway system. She had also traveled to India years earlier.

“We’ve become too complacent about TB, thinking it’s gone away. But the reality is that until it goes away in the developing world, it’s not going away anywhere,” said Watterson.

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