What are the world’s toughest jobs? If you’re making a list, running a tuberculosis (TB) clinic probably isn’t on there. But it should be.
To understand why, meet Dr. Iqbal Master. For the past 25 years, he has been on the front lines of a global public health crisis, leading one of South Africa’s busiest TB clinics at King Dinuzulu Hospital in Durban. In recent years, the number of patients infected with TB has surged alongside an increase in co-infection with HIV and a spike in multi-drug resistant TB (MDR-TB) cases. Dr. Master and his team now treat approximately 1,800 drug-resistant TB cases per month.
TB is highly contagious – 1 untreated person can infect 10 to 15 people per year – and it’s now the deadliest infectious disease in the world ahead of HIV, hepatitis and influenza. More than 10 million people are infected each year and nearly 2 million die from the disease.
But if TB is bad, MDR-TB is far worse. Patients diagnosed with MDR-TB face a stark reality: certain antibiotics don’t work. Many patients encounter stigma from their communities and are unable to comply with their treatment regimens. Helping people to recover from TB requires superhuman levels of patience, resourcefulness and compassion.
“This disease knows no boundaries. People in the prime of their life, children, wealthy, poor. It infects them all and shatters any semblance of normal living,” said Dr. Master. “We become quite close with patients during their long treatment journey and we see how despair can overcome them. Our job is to do more than administer drugs; it’s to restore hope to people during their darkest hours.”
New research data underscores the urgency to prioritize funding for TB control and treatment programs. The US Centers for Disease Control and Prevention now estimates that MDR-TB cases will increase dramatically in the next 20 years, particularly in Russia, India, the Philippines and South Africa. This worrying trend, while it should encourage us to better manage existing regimens, also serves as a reminder that we need to accelerate the pace of innovation needs to stay several steps ahead of the resistance to current antibiotics.
Dr. Master knows what’s at stake and has been an outspoken champion for expanding access to new treatment options that can fight MDR-TB, such as bedaquiline. “A few years ago, we had very few treatment options and patients knew their odds of surviving were slim.” he said. “Then came some new innovations, and now we at least have a fighting chance. But we need to make sure more patients have access in clinics that know how to administer treatment in a responsible way. The most recent innovations are now our last line of defense against drug-resistant TB.”
Countries are beginning to expand the number of clinics and health workers trained to administer bedaquiline, and there are programs available to ensure needy patients can receive the medicine affordably, or at no cost at all.
Read More: Why There’s Hope for the Global TB Epidemic
This won’t make work any easier for Dr. Master and other health workers fighting TB around the world, but it offers a positive sign that things are moving in the right direction to fight this ancient disease.
“We can’t afford to give up on the hope that TB may one day be defeated. We achieve things by trying for the impossible and sometimes we get there,” he said.
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