Word: tb
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...idealist young wife Tessa prompts career diplomat Justin Quayle, a member of the British High Commission in Nairobi, to investigate the humanitarian causes that she lived--and may have died--for. Before long, the widower finds himself on the trail of a shadowy pharmaceutical multinational selling a questionable TB drug to Africans. No one plays this sort of cat-and-mouse game better than Le Carre, although this time good and evil are a tad too easy to tell apart...
Overuse is just part of the problem, however. The evolution of resistance really goes into fast-forward when patients with serious diseases like malaria and TB do not follow doctor's orders, often because they are poor and cannot afford a full course of medication. Instead, they take just enough medication to alleviate their symptoms but not enough to rid their system of the original infection. This has the effect of eliminating the drug-sensitive microbes from the lineup and encouraging the drug-resistant ones to grow...
...staphylococci, which have ballooned into a huge problem for nursing homes and hospitals. But while that is the most attractive commercial market, a number of American pharmaceutical companies are also participating in private-public partnerships aimed at resolving the global health crisis created by drug-resistant malaria and TB. At present, neither disease is a tremendous problem in the U.S. or Western Europe, but that happy situation may not last forever, especially where TB is concerned. In 1992, at the height of a mini-epidemic in New York City, 3,800 new cases of TB erupted; hardest hit were AIDS...
Until recently, the outlook for patients with drug-resistant TB could not have been gloomier. The last major anti-TB drug, rifampin, was approved more than a quarter-century ago. In the interim, the TB bacillus has managed to develop resistance to the cocktail of drugs physicians have long used to treat it, including that old standby streptomycin. New drugs, with different mechanisms of action, would be a great help, particularly if they shortened the present six months' time required for treatment. The linezolid family, for example, appears to hold some promise, as does a compound the Seattle-based PathoGenesis...
...microbes that cause such diseases as TB and malaria will never stop evolving, warns Columbia University epidemiologist Dr. Stephen Morse, and they will develop resistance to the next generation of miracle drugs just as they did in the past. How fast they do so is in large part up to us. With antibiotics, too little is not a good thing, observes Morse, and neither is too much. Unless we devise a formula that is just right, he predicts, we will forever be frantically racing to catch up with our nimbler microbial foes...