Delia Goletti, M.D., Ph.D, spends every single day fighting an infectious disease that should not – on the face of it – be difficult to defeat. It is not a new virus, like HIV was in the 1980s or SARS was two decades later. On the contrary, the disease has been around for as long as mankind, and the bacterium at its root has been known for more than a century.
It does not spread as easily as measles, rubella or influenza, but without treatment, its mortality rate is similar to Ebola’s. Yet, it is a disease that often goes unnoticed. As a matter of fact, the infection is harmless for most healthy individuals.
But it is one of the most common chronic infections in the world and when it does cause vague symptoms weeks to decades later – mainly cough, weight loss, low-grade fever, and fatigue – its airborne flight infects 10 others and a long and difficult drug therapy is needed to cure it. Its name? Tuberculosis (TB).
Tuberculosis has reclaimed a spot among the top 10 killers globally. More than 1.6 million people succumbed to it in 2016, according to a World Health Organization report. More than AIDS, far more than malaria, disproportionately more than Ebola. And despite efforts to curb the epidemic, there were more than 10 million new cases worldwide in 2016.
"There are many reasons that make tuberculosis difficult to fight,” Goletti explains in her office at Italy’s National Institute for Infectious Diseases (INMI) in Rome. Good socioeconomic conditions are the best defense against Mycobacterium tuberculosis, the bacteria that causes TB, according to Goletti.
The infection thrives in developing countries where malnutrition weakens the immune system of the poorest people. In most developed countries, improved nutrition and hygiene were enough to turn tuberculosis into a rare disease by the early 1950s. Which, paradoxically, led to a second problem: Wealthy nations focused on what seemed like more pressing health issues.
Delia Goletti, M.D., Ph.D, Head of the Translational Research Unit at INMI in Rome, Italy, calls for a political commitment to drastically reduce the incidence of tuberculosis globally.