We know that tuberculosis is a problem in sub-Saharan Africa. Multi-drug resistance is on the rise there. Books and movies, like The Constant Gardener, might want to blame us, but the problem stems from the health care system. If we are to blame, it is only for allowing that health care system to continue.
Extreme drug resistance, though, scares the most blase in the health community. This is untreatable TB, deadly, and apparently as virulent as any other strain. We don't know how far it has spread, since most hospitals in sub-Saharan Africa can't test for it. We don't know how many strains there are, since ditto. We don't know if it's waiting to explode in the population.
We do know that most cases have been in AIDS patients. This is a big risk for the immunocompromised. Everyone else? We don't know. We do know that the inability of low income health care systems to provide follow-up to TB patients is probably spurring the development of resistance. How do we fix that? We don't know.
Ignorance is the most frightening concept to any medical professional. We are trained to know before we do, to find the answers. We need to start asking the questions.
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