From my numerous observations, I conclude that these tubercle bacilli occur in all tuberculous disorders, and that they are distinguishable from all other microorganisms.
TB in the world
Every year, more people die due to tuberculosis (TB) than any other infectious disease. This is in spite of the fact that we have had tests to diagnose both active disease (chest radiography and sputum smear microscopy) and the presence of infection (tuberculin skin test) for more than a century, as well as effective first-line drugs (isoniazid, rifampicin, pyrazinamide and ethambutol) for more than half a century.
Hence, it is a testament to our collective failure as a global community that, in 2017, over 10 million people develop the disease each year (half a million of whom are infected with strains resistant to first-line drugs), nearly two million people die from TB, including an estimated 190 000 children less than 5 years of age, and a staggering 1.7 billion people globally are infected with Mycobacterium tuberculosis.
TB in Australia & the Asia Pacific
The fact that TB remains the number-one infectious disease killer on the planet reflects failures in the health system. This is evidenced by the huge inequality in the global TB disease burden with near elimination in some countries, demonstrating that this is possible with existing tools, but ongoing epidemic disease in others. In the era of global trade, migration and travel these gradients are not sustainable, even with border controls and health checks.
In Australia, 89% of cases of active TB occur in people who were born overseas, largely in our region. Elimination of TB in Australia cannot be achieved unless we make major progress towards the control of TB in the Asia-Pacific region. We need to find, treat and prevent TB on both sides of our border.
TB Challenges in our Region
The WHO “End TB Strategy” 2016 to 2035 articulates several major barriers to achieving a decline in TB incidence.
The TB CRE addresses each of these barriers to TB control in both Australia and our region.
The “missing 4 million” active TB cases that are not diagnosed each year and continue to transmit the disease
The massive global reservoir of latent TB infection (LTBI), that includes 5% of the Australian population.
The emergence, spread and amplification of drug-resistant (DR) TB