DRUG-RESISTANT TUBERCULOSISFROM MOLECULES TO MACRO-ECONOMICS

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Introduction

PETER DAVIES

Consultant Respiratory Physician, Cardiothoracic Centre, Liverpool L14 3PE, U.K.

For two days in March 2001, approximately 200 people—medical doctors, scien-tists, legal experts, anthropologists, nurses, and others—met to discuss the problemof drug-resistant, and specifically multidrug-resistant, tuberculosis. The topics cov-ered were exhaustive. They varied from the purely medical and scientific to the legaland economic implications of the disease.

A summary of topics is provided in the roundup article at the end of the sectionon multidrug-resistant tuberculosis. As ever in the rapidly changing fields of scienceand medicine, events have moved on, even in the few months it has taken to compilethe manuscripts from the meeting. In particular the concern about costs raised byFarmer’s enthusiastic support of the “DOTS-plus” strategy have been partially an-swered by the willingness of pharmaceutical companies to reduce the costs ofsecond-line drugs used in the treatment of drug-resistant tuberculosis.1

There still remains an immense task in convincing governments and other fund-ing organizations of the importance of developing new strategies for the preventionand control of this disease, the most important of these being the development of newvaccines and drugs. In the meantime, the practicalities of management with what wehave at our disposal remain a problem. The implications for society as a potentiallyfatal communicable disease increases its incidence have not been fully explored. Inparticular the issues of human rights and detainment of patients in the face of an in-curable condition need wider debate.

We hope that these papers will be of value in moving the debate forward andeventually will play a part in controlling and even eradicating this deadly problem.

REFERENCE

1. COGHLAN, ANDY. 2001. Lives before profit. Drug companies slash the cost of treatingresistant TB. New Sci. 171(2298): 6.