Writing in the British Medical Journal, Stephen Lawn says among the 536 confirmed TB cases there, 41 percent were multi-drug resistant. He says among those, a quarter of the cases were the extensively drug resistant strain referred to as XDR-TB. "The problem in this outbreak is that the bugs were not susceptible to the drugs and people will have remained highly infectious for long periods."
Lawn, senior lecturer at the University of Cape Town, says many South Africans, already weakened by HIV-AIDS, are even more vulnerable to XDR-TB. And he says South Africa is not an isolated example, pointing to results of a WHO/CDC survey that confirm the presence of XDR strains in many parts of the world. "They found that the rates of multi-drug resistant TB were around 20 percent and that 10 percent of the isolates actually had XDR-TB and were found particularly high in the countries of the former Soviet bloc in Eastern Europe and also in East Asia."
Lawn says the findings demonstrate that where TB control practices are poor, the infection can become more and more resistant to drugs. "We know that unless there is the funding, the political will, the public health infrastructure, unless these things are taken seriously and properly funded, TB will continue to evade our best attempts to control it. It will continue to become more resistant and more and more of a menace."
Stephen Lawn says control requires improved means of diagnosis, early detection of drug resistance and a massive broader commitment from the nations of the world.