The body of Simon Bolivar, father of the Latin American revolutions, was exhumed last week in Venezuela. Hugo Chavez, Venezuela's president, is pursuing a hunch that Bolivar died of some nefarious violent act, and not, as the official story holds, of tuberculosis.
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The story is a reminder of how deeply tuberculosis, or TB, has been wound up in human history. Through the ages, it was ubiquitous and feared, a slow cruel killer. A passage from the Old Testament illustrates graphically the dread around TB: "The Lord shall smite thee with a consumption, and with a fever, and with an inflammation, and with an extreme burning, and with the sword, and with blasting, and with mildew; and they shall pursue thee until thou perish" (Deuteronomy 28:22).
In wealthier countries, TB is largely a distant memory. Yet tuberculosis is not dead. The modern epidemic is, in many parts of the world, a leading killer. A new TB infection occurs somewhere in the world every second, and two billion people carry the TB infection (though most of these cases are latent, and not threatening to individuals). It is therefore a leading challenge, one of the "big three" infectious diseases that global health professionals have at the top of their priority list. Yet, though TB is widespread and highly contagious, the complexity of different strains confounds medicine to this day.
TB is more difficult to treat, both individually and from a public health perspective, than other major infectious diseases, including HIV/AIDS and malaria. It is difficult to diagnose, and treatment regimens are lengthy and exacting. As antibiotics helped defeat TB in the wealthier world, interest in research and development for new treatment options and a vaccine faltered. The recent resurgence of TB - there were 9.4 million new cases and 1.8 million deaths in 2008 besides issues arising from TB and HIV/AIDS co-infection and emerging new, drug-resistant TB strains -- has spurred increased TB-related awareness and activity.
The difficulties in moving aggressively to deal with TB are linked above all to the fact that it is a disease of poverty, with most TB-related deaths in the world's poorer countries. The difficult diagnostic and treatment regimes are especially hard to follow in poor communities and impose extraordinary burdens on the young adults who are most affected. Action is complicated by the damaging stigma associated with TB. As TB has become closely linked to HIV/AIDS, the stigma is magnified. Changes in physical condition that are common with TB can make infection noticeable and open the door for prejudice, so people postpone treatment or deny their disease. Diagnosis rates are lowest, and treatment abandonment rates highest, where TB stigma is at its most severe.
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SOURCE: The Washington Post | On Faith
Katherine Marshall is a senior fellow at Georgetown's Berkley Center for Religion, Peace and World Affairs, a Visiting Professor, and Executive Director of the World Faiths Development Dialogue.
