Tuberculosis Is the Oldest Pandemic, and Poverty Makes It Continue

The Sityaya family in Khayelitsha, South Africa, all had tuberculosis, except for the baby, who received preventive treatment.Meera Yadav gave birth to her first baby in 2013, when she was a 23-year-old living in a slum in Mumbai, India, with her husband’s family. She was filled with joy and hopes for a bright future. But four months later she began having fevers and coughing up blood.

It was easy for TB to find Yadav. She was living in poverty amid dilapidated houses stacked close together. Mumbai is one of the worst hotspots in India, a nation that accounts for one quarter of all diagnoses worldwide. Her husband took her to a second hospital, where they diagnosed her with MDR-TB . Her treatment now involved 13 different medications, including injections of kanamycin, which can cause permanent hearing loss and kidney impairment. Instead of the six-month course that cures most TB, MDR-TB treatment can last as long as 48 months, with a success rate of only 59 percent.

In 2021 Yadav and another TB survivor filed a petition in the Bombay High Court requesting the national government invalidate the medications’ patents—which expire after 2023—allowing Indian drug companies to manufacture cheaper generic versions. The lawsuit, delayed because of COVID, is unlikely to succeed: India has issued this kind of license only once before, for a cancer drug in 2012.

Apolisi, together with a physician colleague, ensures that children in close contact with her TB patients take the daily preventive medication isoniazid for at least six months, as recommended by the WHO. The practice is routine in wealthy nations but not poorer ones. Last August, Eduardo da Silva, a 22-year-old inmate in a prison in the state of Mato Grosso do Sul in southwestern Brazil, had the misfortune to face all these conditions at once. Locked behind a thick steel door, a tiny hole his only window, da Silva was wracked with fever, cough, chest pain and night sweats. Other convicts forced him to sleep in a corner on the cold floor, thinking he had COVID.

How is it preventable? Aside from obviously staying away from the sick. But once your family member is ill, what are you saying? Resistant strain I mean.

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