Tuberculosis is being a seen as a greater threat to world health now than at any time in the past half-century. The symbiosis of HIV/AIDS with TB in Africa, along with the emergence of multidrug resistant (MDR-TB) and extensively drug restistant TB (XDR-TB) have only heightened concerns in developing countries. Even in a developed country such as the United States the ability of one TB patient to evade travel restrictions can set fears about an epidemic.

Today (June 22), the World Health Organization and the Stop TB Partnership announced that they were launching a $2.2 billion, two-year plan that aims to set international public health systems on a path to providing access to drugs and diagnostic tests to all MDR-TB and XDR-TB patients by 2015.

Much work is needed, as evidenced by recent Health Affairs articles. In the May/June Health Affairs, Jishnu Das and Paul Gertler, relying on vignettes, found that physicians in India only completed 26% of the necessary tasks for treating a patient presenting with tuberculosis.

In the March/April 2006 Health Affairs, David Ridley and colleagues propose a priority review voucher that aims to speed to market drugs to treat high-burden diseases such as TB (and save research and development funds). And in the May/June 2005 issue, Julie Milstien and colleagues proposed a universal standard of risk assessment for vaccine use in disease-endemic countries, a proposal that could help speed products like a TB vaccine to market.

Health Affairs will be publishing a thematic issue on global health financing July 16 with support from the Bill and Melinda Gates Foundation.

For more background on the highly resistant form of TB and the infected traveler, the Centers for Disease Control and Prevention has a terrific resource page with links to congressional testimony, travel itinerary of the infected traveler, investigation timeline, Q&A, and more.