LETTER
The Dismantling of Tuberculosis Control Programs
Lee B. Reichman, MD, MPH
1 January 1993 | Volume 118 Issue 1 | Page 77
TO THE EDITOR:
Outbreaks of multiple-drug-resistant tuberculosis are tragedies that are predictable and preventable [1, 2]. The editorial by Dooley and colleagues [3] calls attention to several aspects of the problem but omits the most serious root cause—the systematic decimation of our health care delivery system by the inaction and neglect of our health establishment [2].
Most of their solutions to control future outbreaks should have been implemented long ago. One such solution, "intensified research to. identify new therapies." (emphasis mine), is invariably stressed by public health officials, politicians, and the media. However, new drug development may cost hundreds of millions of dollars (Centers for Disease Control, Tuberculosis Elimination Division. Personal communication). Furthermore, if a new drug is developed, tested, and approved but is then delivered through the same health care delivery system that brought us to our present state, resistance to the new agent is inevitable.
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Author and Article Information
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University of Medicine and Dentistry of New Jersey; 150 Bergen Street; Newark, NJ 07103
1. Reichman LB. The U shaped curve of concern (Editorial). Am Rev Respir Dis. 1991; 144:741-2.
2. Brudney K, Dobkin J. Resurgent tuberculosis in New York City; HIV, homelessness, and the decline of TB control programs. Am Respir Dis. 1991; 144:745.
3. Dooley S, Jarvis WR, Martone WJ, Snider DE. Multidrug-resistant tuberculosis (Editorial). Ann Intern Med. 1992; 177:257-9.
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