Tuberculosis, Drug Resistance, and the History of Modern Medicine

Tuberculosis is a treatable airborne infectious disease that kills almost 2 million people every year. Multidrug-resistant (MDR) tuberculosis ? by convention, a disease caused by strains of Mycobacterium tuberculosis that are resistant to isoniazid and rifampin, the backbone of first-line antituberculosis treatment ? afflicts an estimated 500,000 new patients annually. Resistance to antituberculosis agents has been studied since the 1940s; blueprints for containing MDR tuberculosis were laid out in the clinical literature and in practice, in several settings, more than 20 years ago.1,2 Yet today, barely 0.5% of persons with newly diagnosed MDR tuberculosis worldwide receive treatment that is . . .