Progress and Challenges in the Global Fight Against Tuberculosis

Dr. Atul Gawande

In a recent New York Times essay, Dr. Atul Gawande shed light on the ongoing battle against tuberculosis (TB), particularly in low-income countries. Despite being largely controlled in wealthy nations, TB remains the world’s leading infectious disease killer, claiming over a million lives annually.

Gawande, a prominent surgeon, and public health researcher, is the assistant administrator for global health at the United States Agency for International Development (USAID), which plays a large role in the global fight against TB.

In the essay, he described visiting a homeless shelter in Delhi, India, where TB is rampant. This experience illustrates the stark contrast in TB prevalence between high-income and low-income countries: In Delhi’s homeless population, one in every 12 people has active TB, compared to just one in 38,000 Americans.

USAID’s global tuberculosis strategy, which can be read here.

There have been recent advances in TB screening, prevention, and treatment that offer hope for significant progress. These include portable digital X-ray equipment with AI-assisted readings, shorter and more effective drug regimens, and reduced costs for medicines and tests. Gawande emphasized that success in combating TB requires commitment from governments, the private sector, and civil society organizations in countries with a high burden of TB, as well as sustained support from wealthy nations.

India’s efforts are an important example of progress, with increased government funding and improved diagnosis and treatment rates. However, Gawande notes that challenges remain, including inconsistent medical supplies and the need to extend comprehensive TB care to more high-risk locations.

Gawande is cautiously optimistic, acknowledging the potential impact of these new tools and approaches on reducing TB globally. But he stressed the importance of global commitment to enable their wide deployment.

“After decades without major advances, we now have a steady stream of innovations. But they won’t matter unless the world commits to deploying them,” Gawande concluded.


Read the full essay by Dr. Gawande from The New York Times, August 16, 2024: We Now Have a Chance to Stop the Most Deadly Infectious Disease — if We Act (gift article)

Watch Dr. Gawande’s speech at the 77th World Health Assembly, where he spoke about advances in TB diagnosis:

At the 77th World Health Assembly, USAID’s Assistant Administrator for Global Health, Atul Gawande, discussed how AI is improving the TB detection process. These solutions, coupled with molecular diagnosis, are aiding seven countries, including Vietnam and Nigeria, in improving TB case detection by over 33%. These solutions ease the burden on healthcare workers and speed up diagnosis and treatment.

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