Spiral Notebook: Why the next epidemic is only a cough and a spit away



By Giles Broadbent

Go to the Tuberculosis page on the NHS "Choices" website and read the reassuring list of treatments available.

With early diagnosis, the right combination of drugs and aggressive treatment the disease is curable.

In Swaziland, the story is different. In a country plagued by Aids, immune systems are shot, drug treatments are old, stigmatism forces carriers into hiding and the mismanagement of drug regimes gives the bacteria a foothold. The disease is mutating into super-strains.

If TB is bad enough; multi-drug resistant TB (MDR-TB) is cruel; and the "X" in XDR-TB (extensively drug resistant TB) is there for a reason.

Why, ask the medics in Jezza Neumann's documentary Return Of The Plague to be broadcast on BBC4 shortly, are Western countries ignoring the plight in Swaziland?

In an era of globalisation, Swaziland is next door. It's a cough and a spit away. "TB is in the air, whether you're poor or rich you can't stop that," says one dying sufferer.

Already London has the highest TB rates of any western European capital. London has 42 cases per 100,000 people compared to Paris (23) and Copenhagen (17). Newham is the worst hit at 118, Greenwich 51 and Tower Hamlets 46.

Scientists have called for a dramatic increase in screening to prevent an epidemic.
As mutations begin to take hold, the "Choices" offered by the NHS may become worryingly limited.

Follow Giles Broadbent on Twitter: @MediaGulch

Image: Medecins Sans Frontieres

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