Many people consider tuberculosis (TB) as a plague of the past, not imagining for a second that they might contract it. While the number of TB cases in the world has gradually decreased the disease has not disappeared.
In 2016, the World Health Organization (WHO) estimated that a third of the world population was infected with Mycobacterium tuberculosis (the bacteria responsible for tuberculosis), that there were 10.4 million new infections (equivalent to 140 cases per 100,000 people) and that 1.7 million deaths were attributed to the disease. Currently, TB is among the top 10 causes of death worldwide and the first cause of death due to an infectious agent. Today, it remains a real public health issue.
The history of tuberculosis changed drastically on March 24, 1882 when Robert Koch (awarded the Nobel Prize in Physiology or Medicine in 1905) demonstrated this disease was the result of an infectious process due to the initially called tubercle bacilli (then named Mycobacterium tuberculosis). After decades of various treatments the modern fight against TB started in 1944 with the isolation of streptomycin, the first antibiotic that killed the bacilli. The first bactericidal antibiotics to be administered orally, isoniazid and rifampicin, were discovered in 1952 and 1957, and today still constitute the cornerstone of first-line tuberculosis treatment. In parallel, the BCG vaccine for prevention of the infection was first used in humans in 1921. The world believed it was rid of TB but in the 1980s, the disease made a comeback mainly due to the beginning of the HIV epidemic. Ten years later, it was the emergence of a form resistant to current treatments. In response to the resurgence of TB, WHO declared a global health emergency in 1993. More than a decade later, in May 2014, the World Health Assembly, convened by the WHO, approved the END TB Strategy to stop the global TB epidemic with the goal of reducing the number of deaths by 95% and the incidence of the disease by 90% by 2035.
As a result, the global incidence of TB has decreased, with an 18% drop in the number of new cases since 2000. The associated mortality rate has almost been halved since 1990. However, to reach the END TB Strategy goals there needs to be a further 4-5% drop in TB mortality and a 10% drop in TB incidence by 2020. The new WHO strategy aims to accelerate detection and improve the outcome of TB treatment by using a new rapid diagnostic test and a shorter and cheaper treatment regimen.
On March 24, World Tuberculosis Day, initiated by WHO, is designed to build public awareness around the disease and encourage a global commitment to end the TB epidemic, a disease that is as old as mankind. In ancient times, it was called consumption, which meant withering. The Greek physician Hippocrates described it as a pulmonary infection and defined its symptoms as weight loss, coughing and blood in excretion that gradually led to death. In the 20th century, TB took the lives of some of the most famous personalities of the 20th century including Chopin, Kafka and Chekhov.