The Silent Killer

Wednesday is World Health Day, an opportunity for the World Health Organization (WHO) to raise awareness and appeal to governments around the world to invest more money in treatment and vaccines for some of the world's most stubborn diseases. Tuberculosis is on that list.

Dubbed "the silent killer", it claims some two million lives a year, despite the fact that it is usually relatively easy and inexpensive to treat. It also costs the world economy billions.

"Three quarters of TB patients are young adults in the middle of the working lives," said Jose Maria Figueres, co-director of the World Economic Forum. "Tuberculosis contributes to a yearly loss of $12 billion in productivity." That's all the more reason to stamp it out.

But in a double whammy, the scourge of HIV has contributed to the disease's comeback.

Now there is new cause for concern. According to a WHO report released in March, multi-drug resistant tuberculosis (MDR-TB), where a patient has a form of the disease that is resistant to two or more drugs, is on the rise in many countries, including three -- Estonia, Lithuania and Latvia -- due to enter the European Union in May.

HIV contributes to spread

Today, tuberculosis does not have to be a death sentence. While it is highly infectious -- every person with an active TB infection infects on average an additional 10 to 15 people -- the majority of people who carry the disease do not develop an active infection. For those who do, treatment is usually quite effective.

What has health experts concerned is the deadly double combo of TB and HIV. Those infected with HIV are one hundred times more likely to develop TB, which is one of the largest killers of HIV carriers. The WHO had hoped to stamp out TB by the end of the last century, but HIV has, sadly, interfered with that plan.

"The Aids epidemic has completely changed the environment of TB and has contributed to a new epidemic," said Dr. Peter Piot, the UN-AIDS director, at a forum at the end of March.

EU countries at risk

While TB as it is experienced by those in most developed countries, including many in western Europe, is relatively easy to treat, the proliferation of multi-drug resistant strains (MDR-TB) has health officials in Europe worried.

In March, the WHO released a study pointing to an alarming rise in MDR-TB, estimating 300,000 cases worldwide. The majority of those are concentrated in hot spots, including three countries due to join the European Union in May: Estonia, Lithuania and Latvia. Drug resistant rates were up 10 times the average there.

Some EU health ministers worry the public's health will be seriously under threat after May 1, when borders are open to these hotspots. It is, therefore, not surprising that existing EU members have decided to take a more active role. The EU has promised €32 million ($38.6 million) for the development of a new vaccine. In Germany, the Berlin-based Max Planck Institute for Infectious Biology is among the organizations doing its best to make that a reality.