Wall Street Journal Examines Tuberculosis Struggle in South Africa and Its Lessons for AIDS Treatment
The Wall Street Journal in a front-page story today examines South Africa's "losing" battle with tuberculosis and contemplates what the country's failure to treat the curable bacterial infection could mean for the future of AIDS treatment there. Two hundred and fifty thousand South Africans have tuberculosis, a disease that infects the pulmonary system and, if left untreated, can cause "lesions and scarring of the lungs," leading eventually to death. TB can be treated with a $5 six-month course of antibiotics. However, to ensure successful treatment, patients must take their medicine on a regular basis and complete the full course of antibiotics to prevent the emergence of drug-resistant TB strains. About 15% of TB patients in South Africa stop taking their medication or "disappear altogether," according to health workers. Some patients do not have access to clean water to take the drugs, others cannot afford bread to assist in taking the pills and others discontinue treatment when they migrate in search of work. Some do not seek treatment for fear that their employers will discover they are ill and fire them. Many South Africans also "distrust" Western medicine and turn to traditional healers, who sometimes give advice that actually perpetuates the spread of the disease.
A Window into HIV/AIDS Treatment?
Observers "worr[y]" about what the failure to successfully treat TB means for AIDS treatment in South Africa. The country has a 60% success rate for treating TB, "well below" the World Health Organization's target rate of 85%. As access to AIDS drug treatment may become a reality for more Africans as drug prices drop, South Africa's "struggle against TB underscores the challenges of providing cheaper AIDS drugs without a well-funded, comprehensive strategy to distribute the medication and help people take it," the Journal reports. Scientists fear that HIV/AIDS treatment will see similar or higher drop-out rates, because HIV drug regimens are more complex than those for TB, requiring several pills to be taken several times a day, compared to the once daily TB antibiotic. If HIV/AIDS treatment follows TB's example, researchers warn that "Africa could become the breeding ground of a super drug-resistant virus" that could spread around the world (Block, Wall Street Journal, 4/26).