CDC History of Tuberculosis Control - Medical and Public Health ...

company trying at that time to license a new
drug with admitted TB indications.
At that time I stated that drug companies
don’t sit with us at the TB table because as
public corporations they must ask, “What’s in
it for us?” To a great extent, if we want them
with us, there must be something in it for
them beyond “doing good,” a virtue that
shareholders and financial analysts probably
understand less well than even politicians.
I’m not the only one suggesting this. In Business
Week, April 6, 1998, the cover story
stated: “Still, TB, like malaria, attracts fewer
resources than other infectious diseases. And
it’s not hard to figure out why. . . There’s
been the least effort to develop new antiinfectives
(against these diseases) because of the
inability of the population in the most affected
areas to pay. That’s just one reason the war
with microbes may never be fully won. Companies
and nations need to launch — and
maintain — effective campaigns not only
against strep and flu but also against the
scourges that ravage far too many of the
world’s people. Only then would we have a
chance of relegating these killers to the pages
of our history books.”
So in response, we need to define strategies to
allow drug and technology companies to be
full prospective players, along with government
and nongovernment organizations,
academe and foundations. Let’s find out what
they need and want, and then let’s provide
them with incentives and enablers; let them
promote their wares as well as promote our
needs. And let’s let them earn a fair and
proper profit for what they do.
Many years ago, the IUATLD Council (I
think it was 1979 in Brussels) held an extensively
prolonged discussion over whether the
Bulletin of IUATLD, the predecessor to the
International Journal of Tuberculosis and Lung
Disease, would be irreparably corrupted if it
accepted paid advertising. But TB control is
Notable Events in TB Control
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too fragile and important to attack with only
the usual suspects. Adding unusual suspects as
full participants, such as nongovernmental
organizations, academe, foundations and
industry, is the only way we can ever implement
and carry out the global plan, rectifying
the continuing worldwide embarrassment and
danger of TB.
In 1955, soon after the introduction of widespread
use of TB drug therapy, Professor
James Waring at Colorado pointed out in
JAMA that TB was unique in that, essentially,
it stayed around and spread until it was properly
treated. In other words, it doesn’t go
away.
The global situation with TB reminds me of
the man who advertised FRAM Oil Filters on
television several years ago. In that commercial,
a scruffy garage-mechanic type approached
the camera holding an oil filter in
one hand and a burned out car engine in the
other. He stated: “Last week the owner of this
car could have had a new FRAM Oil Filter for
$4.95. He decided not to buy it. Today he has
to buy a new car engine for $1,275.00.
“You can pay me now. . . or you can pay me
later.”
The Model TB Prevention and Control
Centers: History and Purpose
by Elizabeth J. Stoller, MPH
Former Director, Francis J. Curry National TB Center
and Russ Havlak
Former Assoc. Dir. for Special Projects, DTBE
On January 22-23, 1992, a conference on
multidrug-resistant TB (MDR TB) was held at
CDC in Atlanta. Part of the strategy outlined
in the resulting National Action Plan to Combat
Multidrug-Resistant Tuberculosis was to
establish centers of excellence for treating
difficult-to-manage TB cases, especially MDR
TB cases. The Plan also called for developing a
cadre of health-care professionals with expertise
in the management of TB and MDR TB