The world needs to change its approach to fighting tuberculosis, say researchers in a new paper published in The Lancet. We are going to see worse epidemics and more drug resistance unless there is less reliance on biomedical solutions and a greater emphasis on social action, they urge.

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Although TB deaths have fallen dramatically in recent decades – thanks to improved diagnosis and treatment – the disease still kills over 1.5 million people a year.

The paper, by researchers from Harvard T.H. Chan School of Public Health in Boston, MA, is one of a series that will also be published in a book. The papers put tuberculosis (TB) in context and detail a comprehensive plan to stop TB deaths.

The plan will be implemented through the Zero TB Cities Project, which aims to create “islands of elimination” of the disease.

Senior author Rifat Atun, professor of global health systems, says that despite increased funding, progress on eliminating TB has been “woefully slow,” and:

“We strongly argue that more of the same will not stop tuberculosis. The time has come for comprehensive actions to confront the root causes of tuberculosis, which lie in poverty and deprivation.”

In their paper, he and his colleagues call for a “biosocial” approach that includes programs to tackle nutrition, urban planning, addiction recovery, occupational health and mental health services in the fight to eliminate TB.

Fast facts about TB
  • TB is curable and preventable
  • It is caused by bacteria that spread through the air and infect the lungs
  • About a third of people have latent TB; they are infected but not (yet) ill with the disease.

Learn more about TB

Although TB deaths have fallen by 45% between 1990 and 2013 – thanks to improved diagnosis and treatment – the disease still kills over 1.5 million people a year, according to figures from the World Health Organization (WHO).

Also, drug-resistant strains are increasing. Estimates suggest over 480,000 people developed multidrug resistant TB (MDR-TB) in 2013.

The authors highlight that TB spread is also fueled by social conditions such as malnutrition, overcrowded housing, HIV, diabetes, smoking and drinking too much alcohol.

They say that in developing countries, the benefits of improved diagnostics and treatment are not enough to offset the susceptibility in groups at risk of the disease because of these social conditions.

Thus, the authors argue that future strategies need to combine the biomedical approach with social action, as Prof. Atun explains:

A biosocial approach to stopping tuberculosis will not only reduce morbidity and mortality from disease but would also alleviate poverty and help sustainable development. It will meet present needs for the poor and provide them and subsequent generations with an opportunity for a better future.”

In 2014, Medical News Today learned that TB is more widespread than previously thought. The revelation followed a data collection drive by WHO and by multiple partners.