Can Tuberculosis Be Eradicated?

¹ Director Emeritus, Chest Disease Bureau, Department of Health, Emeritus Physician in Charge, Tuberculosis Control, Division of Health

Progress has been made in the struggle against tuberculosis and will continue to be made with intensive efforts in control procedures. Results are apparent in the United States, in Canada and in some areas of Northwestern Europe. In other parts of the world, advance has been slow. The "magic bullet" has not been discovered and even with the unearthing of such a drug or combination of drugs that will destroy the tubercle bacillus, eradication will not occur as all active infectious cases cannot be treated at the same time. When we consider the 25 per cent of patients who fail to respond to chemotherapy, the high percentage of unknown cases never recognized until after death, the increasing number developing drug resistance, and the morbidity and mortality rates of tuberculosis in many countries, eradication appears impossible. About ten years ago, syphilis was considered on the road to extermination in the United States. At the annual meeting of the American Public Health Association in October, 1943, Dr. John Mahoney reported the successful use of penicillin, and in 1954, a single injection of benzathine penicillin G became the recognized treatment for early syphilis. Statistics demonstrate that instead of diminishing, syphilis is on the increase, and between 1959 and 1960 increased 59 per cent in the 15 to 19 year age group, and 73 per cent in the 20 to 24 year age group. The total of 18,781 reported cases of infectious syphilis in this country in 1961 not only was double that of the 1960 rate, but triple the 1959 rate and the greatest reported since 1950. Knowing the manner of wiping out a disease does not eliminate it. In smallpox, the method of eradication has been known since 1798, yet over 400,000 new cases are reported annually throughout the world. Tuberculosis in the United States still accounts for more than 10,000 deaths a year, approximately 55,000 new cases reported annually, a prevalence of 250,000 active cases with at least 35,000,000 people infected with tubercle bacilli as revealed by the tuberculin test. Intensive case-finding procedures and modern therapy can reduce morbidity and mortality rates and lower the expenditures of tuberculosis, which have been estimated at $700,000,000.00 a year in the United States.