Tuberculosis, which typically ravages the lungs, is a disease we associate with the past: Mimi, the heroine of Puccini's La bohème, had tuberculosis; so did Fantine in Les Misérables. Many of the great artists who created our favorite fictional characters — Chekhov, Kafka — died from "consumption," as it was known, too.
Back then, we didn't have treatments or vaccines for TB. But while medical innovations — like the discovery of antibiotics in the 1940s — helped dramatically reduce the incidence of this bacterial infection, a new threat has emerged: drug-resistant tuberculosis.
The World Health Organization now estimates that every year, there are about half a million cases of TB that don't respond to the treatments we have. Drug-resistant strains of the disease, a WHO official said this week, are currently "ravaging" Europe.
The Centers for Disease Control and Prevention, which released its latest TB data today, put a price tag on drug-resistant TB: the average cost of treatment per US case is $134,000, compared with $17,000 to treat a case that responds to drugs. When productivity losses are factored in, the price tag rises to $260,000.
These costs aren't only due to the fact that treatment is expensive, involving daily injections that can last months; there's lost productivity, too. "Patients face the inability to work, long and frequent hospitalizations, home isolation, and even death," the CDC stated. "Medications can also lead to severe health problems, such as hearing or vision loss, liver or kidney damage, depression, or psychosis."
The rate of drug-resistant TB remains low in the US. According to the most recent CDC estimates, there were fewer than 100 cases in 2014. That's just over 1 percent of the total TB disease burden.
Still, the problem is preventable. Tuberculosis, which spreads from person to person through the air, takes on "superbug" proportions when a person gets the wrong treatment or doesn't take the entire course of prescribed antibiotics. (In developing countries, access to good-quality treatments is an issue, too.) So drug-resistant TB originates with improper antibiotic use, and the bacteria mutate to outsmart the drugs we have.
Drug-resistant diseases are a looming threat
Drug resistance isn't just a TB problem. In the US, we've already seen a number of other bacterial infections — gonorrhea, carbapenem-resistant enterobacteriaceae (or CREs) — that no longer respond to any of the drugs we have. Antibiotic-resistant infections are associated with 23,000 deaths and 2 million illnesses every year.
The CDC has estimated that these superbugs lead to $20 billion a year in excess health-care costs, as well as more than 8 million additional days that people spend in hospital.
A recent report commissioned by the UK government contains an alarming prediction: by 2050, antimicrobial-resistant infections will kill 10 million people across the world — more than the current toll from cancer.
This nightmare scenario isn't that far-fetched for one simple reason: we keep failing to muster the action needed to stave it off. There has been an incredible amount of inertia in medicine, and the agricultural sector has for years denied the science for economic and political reasons.
To learn more about the problem of antibiotic resistance, read 7 scary facts about antibiotic-resistant superbugs.