The Global Epidemic of TB

This article was originally published by Scientific American

Unless you’ve been distanced from the news and the internet, you have heard that tuberculosis has become increasingly drug resistant and is resurging in many areas of the world and this is much more than a minor inconvenience.

Kari Stoever, the Vice President of External Affairs at Aeras – a global nonprofit biotech advancing TB vaccines for the world, has put together a team to create an educational series of videos, which are available in its entirety for screenings, to raise awareness about the re-emerging infectiousness and virulence of pulmonary TB across the world.

From the description on Vimeo:

“Natalie Skipper survived multidrug-resistant tuberculosis, but not before it flipped her life upside down. We weave together Natalie’s story – which took place in Nashville, Tennessee – with a global perspective on the pervasive threat posed by TB around the world.

EXPOSED is a four-part series of short films that tells the story of the deadly global epidemic of tuberculosis. The series focuses on current efforts to halt this airborne disease, which is growing more difficult to address, as well as the urgent movement to develop new tools to prevent it. By telling the stories of four inspiring individuals interspersed with expert commentary from some of the world’s top TB physicians, scientists, advocates and policymakers, EXPOSED brings viewers to the forefront of the race against tuberculosis. For more information, go to aeras.org/exposed.
We need your help to spread the word. Watch and share at aeras.org/exposed. To organize a screening, email film@aeras.org.
EXPOSED is produced by Aeras, a nonprofit biotech advancing tuberculosis vaccines for the world. The series is developed in partnership with filmmaker Mo Scarpelli of RAKE FILMS with support from GATHER.”

 

In February, I was in India with the International Reporting Project to look at issues of child survival, and saw, first hand, issues related to TB in many slum and settlement dwellers, where TB is estimated to affect 40% of the Indian population, most of the cases being latent, not active. This image shows the microscope and staining reagents seen in the ever present small TB testing storefronts that are scattered throughout India. Anyone may stop by and submit a sample of sputum to have it visually assessed for the presence of Mycobacterium tuberculosis for a small fee.

 

Chapter 2: The Rise of a Superbug

The second video in the EXPOSED series takes us to Delhi, India where we meet a doctor who treats TB in his practice. It then introduces us to a DOT center (Directly Observed Therapy, short-course).

http://vimeo.com/66641359

From the video description: “Dr. Jayant Banavaliker, a leading TB doctor in Delhi, chronicles his daily struggle to save patients using today’s antiquated tools: diagnostics barely more predictable than chance, drugs that can be toxic and weak against the pathogen, and a vaccine with limited protection. We also travel to South Africa, where Phumeza Tisile tells the harrowing story of her near-death experience with extensively drug-resistant TB.”

<–Mumbai physician with mHealth device to assist with drug compliance in TB patients.

As seen in the above video, compliance with the extensive drug treatment for ever-growing-drug-resistant TB is a constant struggle. Fortunately, technology may be able to assist with compliance. With the penetrance of mobile technology being greater than 50% in India (with expected variability between cities, slums, settlements and rural areas), many health practitioners are employing various versions of mHealth (mobile health), which is the practice of medicine and public health, supported by mobile devices, to manage long term treatment, where multiple visits to physicians can be a hardship or inconvenience. Examples of mHealth use in India include sending mothers-to-be reminders of important check-ups and diet and care tips during pregnancy and after delivery, reminding mothers to bring children in for scheduled vaccinations, managing diabetes care and enforcing TB drug compliance. The image to the right shows a clinic in Mumbai and the physician with his device that sends reminders and receives data of medication taken daily for drug treatment by the TB patients in his care, saving them additional trips to the DOT center.

Chapter 3: The Innovation Movement

http://vimeo.com/66641357

“Unathi Gwintsa lives with her daughter in Worcester, South Africa, a community devastated by TB. But she’s not sitting back and waiting for the answer. She has volunteered in a clinical trial of one of a dozen TB vaccine candidates in clinical development. We follow her story along with others working tirelessly to rid their communities and the planet of TB.”

Chapter 4: The Last Mile

http://vimeo.com/66641358

“Professor Helen McShane has dedicated the last 12 years of her life to developing a new tuberculosis vaccine. We follow her team’s unprecedented work at Oxford University and explore why now is a pivotal moment in history to save millions of lives and end the TB epidemic.”

All photos by Joanne from her IRP trip to India.