Is hope on the horizon for treating drug-resistant TB?
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What is the history and current state of tuberculosis?
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You can't just treat a person with that disease as if it's like you just got a bug that you're treating. You're treating a person who has a whole lot of other things going on with them. And you've got to understand how those work together.
Welcome to When Science Finds a Way, a podcast about the science changing the world. I'm Alicia Wainwright, and on this series, I'm talking to the global experts who are making a difference, as well as the people who have inspired and contributed to their work. This episode is about ending the world's deadliest infectious disease, tuberculosis, or TB. TB is contagious and airborne. In 2024, 10 million people were diagnosed with TB, and it caused over a million deaths. TB is preventable and curable with the right treatment. But this is complicated by the emergence of drug-resistant strains of the disease. These strains are not susceptible to the usual frontline treatment and require special diagnostic tests and drug regimens.
And this is a challenge because the TB burden falls disproportionately on settings and populations in which these resources may not be easily accessible. Joining me to discuss TV is Professor Salome Charlombus, Group Chief Health Officer at the Orem Institute in South Africa. Salome has been in this field for years, and the organization is involved in research, clinical trials, policy, and frontline health services for infectious disease in the country. So let me describe the scale of the challenge of drug-resistant TB and the funding gap for prevention, diagnosis, treatment, and care. But there's also hope here with so much progress that's already been made and some breakthroughs on the horizon.
So let's give a general definition of tuberculosis. What is it and how does it spread?
So TB is caused by a germ, the germ we call mycobacterium tuberculosis. And it really is spread when people breathe in droplets that have got TB in them. Basically, what happens to a lot of us that live in a country with high rates of TB, including myself and especially healthcare workers, is that we breathe in these droplets very young, so as children. And what happens is that the TB goes into your body and it actually forms what we call a gonfocus, which is a little like nodule in your lung. And then later on in life, when your immune system is suppressed or you're under stress, or sometimes when you get reinfected by another TB bacillus, you can then develop what we call TB disease. Yes. And so that we call that active TB.
And active TB, usually people have a cough and the other classic symptoms are night sweats, sweating at night and weight loss. But it can be that you can also be completely asymptomatic. So that's a new thing that we found out recently is that someone can have TB disease and at the beginning be asymptomatic. In other words, doesn't have those classic symptoms of TB, but actually have it. So that also causes us some problems sometimes in diagnosing TB in those people. But those are the classic symptoms, cough, weight loss, and night sweats.
I think when I was preparing for this episode, I hadn't fully understood that many people carry TB with them and are asymptomatic. That was new information to me. I was aware that TB was a slow-moving disease sometimes. It took people a long time to either recover from it or succumb to it. But I hadn't considered that you could be carrying this germ with you in a nodule in your lungs for maybe even decades before you found yourself having active TB.
In some ways, it makes it a very interesting disease to study because there's so many different facets to it and so many difficulties that we face with identifying TB, treating TB.
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