Next Challenges for TB
By Sandy K. Johnson

The next frontier in the fight against tuberculosis is linked to diabetes.

TB infected 9 million people worldwide in 2013. Of those, 1.5 million died, including 360,000 who were HIV positive, according to new statistics released last week by the World Health Organization. Experts have focused in recent years on patients struggling with both HIV and TB.

Now, two longtime TB researchers say the next front in the fight against tuberculosis is diabetes.

“If I am TB infected and I develop diabetes, I have a 30 percent lifetime risk of (full-blown) TB,” said Brown University researcher Dr. E. Jane Carter.

Carter, who is the current president of the International Union Against Tuberculosis and Lung Disease, was the leadoff speaker at the National Press Foundation’s J2J Lung Health media training.

She identified China and India as two nations to watch because both have obesity and growing diabetes issues. “In those two very large countries, this is what is going to drive TB in the next year.”

Dr. Anthony Harries agreed. He said India already has 302,000 people with both TB and diabetes; China has 156,000. That’s almost half of people worldwide (1,042,000) who have both diseases.

The foreboding part, Harries said, is that India has 63 million diabetics and 2.2 million new TB cases per year while China has 92 million diabetics and 1 million new TB cases every year. The prospect for more double-afflicted people is daunting.

Harries blamed the rise of diabetes on “rapid urbanization, changes in lifestyle, more fast food, less exercise.”

Both experts said cross-screening for both diseases is critical for effective treatment. Cost is also factor – while TB treatment is almost universally free, diabetes is a life-long condition that is expensive to treat.