TB SYMPOSIUM - Keynote speech, Mario Raviglione


The era of anti-TB chemotherapy only started some 70 years ago, very late in the intertwined history of humanity and TB. The optimism that accompanied the introduction of what were at the time "wonder drugs" was quickly dampened by the realization that resistance to them emerged very fast.

This has complicated the treatment of TB ever since, making drug regimens more complicated, toxic, and protracted. The likelihood of a successful outcome of treatment diminishes as patients with resistant strains fail to resolve their disease despite receiving medications, decide to abandon their treatment, or die.

Drug-resistance emerges and propagates as a result of inadequate treatment and poor infection control. Modelling work, supported by some data from eastern Europe and elsewhere, shows that resistant strains can become very frequent if allowed to spread unchecked.