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Caring about tuberculosis: IUATLD's continuing contributions

Few people know that the global burden of tuberculosis is steadily worsening, and that urgent action is desperately needed. Here are the facts: in 1999, there were an estimated 8.4 million new cases, up from 8.0 million in 1997; if present trends continue, 10.2 million new cases are expected in 2005, 1 and as has been true for a long time, 95% of all new cases of tuberculosis in the world and 98% of deaths will continue to occur in low-income countries. These are deplorable figures, which reflect as much (or more) on the failure of the society we live in as on the inherent pathogenicity and virulence of Mycobacterium tuberculosis . Tuberculosis is not especially difficult to diagnose; effective and inexpensive drugs to treat it have been available for over 40 years; when medications are properly prescribed, made available, and taken, the disease can be cured in over 95% of all afflicted patients; and, in certain high-risk persons, progression from latent infection to clinically active disease can even be prevented. Complacency, failure to face reality, and lack of will, have all contributed to the current deteriorating global situation. One organization, however, has remained resolutely on the frontlines in the battle against tuberculosis for over 70 years: the International Union Against Tuberculosis and Lung Disease (IUATLD)*. Alone for much of this period, the IUATLD has now been joined by several dedicated partners in a collaborative multifaceted effort to combat tuberculosis and its pathogenic allies, HIV infection and poverty, throughout the world. The purpose of this editorial is to review briefly the historical underpinnings of the IUATLD and its early successes against tuberculosis, and then to describe the powerful global coalitions that have coalesced and how they are furthering the ongoing struggle.