Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
BBC News - Tuesday, 26 October, 2004
TB can be easily treated, but Medecins San Frontieres says inadequate attempts to control the disease mean it is now spiralling out of control.
MSF says drug-resistant strains, coupled with HIV pose a major threat.
The charity is calling for massive investment in developing new diagnostic tests and drugs.
New TB drugs and diagnostic tests are being developed by initiatives such as the Global TB Alliance and FIND (Foundation for Innovative New Diagnostics).
However, MSF says action is also required to ensure all people with TB are guaranteed access to care.
Frustration
Dr Jean-Herve Bradol, president of MSF France, said: "Tuberculosis is one of our biggest frustrations as medical professionals.
"In the countries MSF works in, TB kills people in the thousands without us being able to detect or treat them properly, or in time."
Dr Francine Mattys, TB advisor of the MSF Campaign for Access to Essential Medicines, said radical action was required to tackle the problem.
She said: "Massive investment in developing new diagnostic tests and drugs is needed now, so that we can effectively diagnose and treat all those with TB in the shortest possible time."
Inadequate test
Most TB programmes in developing countries rely on sputum microscopy for detection of TB.
Developed in 1882, this method only detects the bacilli that cause the disease in about 50% of all people with TB.
Its performance is even poorer in children and people infected with HIV.
Treatment of TB is long and relies on medicines that were invented 40-60 years ago.
Dr Ilse Ramboer, a physician from MSF's TB programme in Guinea Gonakry, said: "In Guinea, and many other developing countries, we regularly see people who have already been treated for TB but return a year or two later with new TB-like symptoms."
"These people could be re-infection cases. But they could also be on their way to developing multidrug-resistant TB - there is no way of telling because most resource-poor settings have no access to drug sensitivity testing."
Experts fear that the combination of multidrug-resistant TB and HIV/Aids could have a devastating impact in Africa.
MSF treats roughly 20,000 TB patients every year in over 30 projects around the world.
The issue will be discussed at the Union World Conference on Lung Health in Paris later this week.
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