Professional Documents
Culture Documents
Jim Yong Kim, MD, PhD Partners In Health Harvard Medical School
June 1997
Publication of the WHO-IUATLD Global Report on Drug Resistance Surveillance
"Where it's in 1 to 2 percent of the cases, then it's not a major factor, but in some places drug resistance is showing up in up to 22 percent of the cases...When you get up in that range, you've got a very serious problem. Treating them with DOTS has no effect. The danger is that in not dealing with multi-drug-resistant strains now, in 20 to 40 years, we could perhaps have a majority of cases be multi-drug-resistant, and that would be like starting over in the fight against TB. Dr. Nils Daulaire, Global Health Council,
Source: Judy Mann, We Skimp on TB Treatment at Our Peril, The Washington Post, November 5, 1999, Pg. C11
August 1996
DOTS-Plus project initiated in Limas Northern Cone by Socios en Salud and Harvard/Partners in Health.
$ 2,000
$ ,534
$4,494 $804
$350
yc in
yc lo
e ro flo xa ci n flo xa ci n
ik ac in
yc in
PA S
an a
re
se r
in
April 199 Participants at Harvard University meeting resolve to initiate DOTS-Plus strategy for treatment of MDR-TB in resource-poor settings
October 1998
Meeting at White House hosted by Hillary Clinton to discuss TB and MDR-TB in the former Soviet Union. Attendees include James Wolfensohn, Gro Harlem Brundtland, George Soros. Mrs. Clinton pledges support for efforts to contain MDR-TB. CDC initiates program in Russia.
January 1999
Meeting at World Health Organization in Geneva of non-governmental organizations and national TB programs interested in starting DOTS-Plus programs. WHO Wor ing Group on DOTS-Plus for MDRTB is established.
August 1999
Submission of application to add nd line anti-TB drugs to the WHO Model List of Essential Drugs
line Drugs
40 30 20 10 0
ll A 1 d ug r 2 dr s ug 3 dr s ug 4 dr s ug M DR
They have moved the dialogue along so that people can stop fighting one another and start fighting the disease.
Source: Judith Miller, In Fight Against Tuberculosis, Experts Look for Private Help, The New York Times, p. A8.
ulou
The costs of the resurgence of tuberculosis have been phenomenal. From 1979 through 1994, there were more than 20,000 excess cases of the disease in New York City Each case cost more than $20,000 in New York dollars, for a total exceeding $400 million. In addition, as many as one third of patients with tuberculosis were hospitalized because of inadequate follow-up Care will [further] be required for those who become ill in the years and decades to come. These costs easily exceed $1 billion and may reach several times that amount. Thus, despite their cost, efforts to control tuberculosis in the United States are like to be highly cost effective. -Thomas Frieden, CDC
CC
Protecting the uture Pay Up Now or Pay More Later Righting Market ailures
Enough Resources for R&D? Effective Incentive Structure? Drug Development Process? Clinical Trials Apparatus? Malaria, Onchocerciasis as Models? Who Will Pay?
Global inequalities in income and living standards have reached grotesque proportions.
oore t iddle i he t
% % % %
% % % % % % % %
Rats and roaches live by competition under the laws of supply and demand; it is the privilege of human beings to live under the laws of justice and mercy.
Wendell Berry