Tuberculosis (TB) kills 1.6 million people every year and another nine million are suffering from the disease. It is the biggest killer of people living with HIV/AIDSin Africa.  Almost half a million people develop multi drug-resistant strains of the disease every year.

TB is a contagious disease that spreads mainly through the air like a common cold, usually affecting the lungs. This form of the disease (pulmonary TB) is characterised primarily by a persistent cough, shortness of breath, weight loss and night sweats.  Only one in ten people infected by the bacteria will actually go on to develop the disease, because a healthy immune system will keep the infection dormant. But these infections can reactivate decades later if the immune system becomes weak.   
 
TB was drastically reduced in wealthy countries over forty years ago. TB control programmes however have failed to wipe out the disease in developing countries, where today, 99% of TB deaths occur.  
 
MSF is struggling against a double crisis in its medical programmes: on the one hand, there is a growing number of patients infected with new strains of TB that are resistant to standard treatments and on the other, there is a rapid spread of TB among people living with HIV/AIDS. The situation is made worse by the lack of reliable, rapid ways to diagnose TB, and doctors are often forced to make treatment decisions without a definitive diagnosis.
 
TB is a global emergency, yet every day MSF staff and other treatment providers struggle to tackle the crisis without access to the medical tools they need -  both adequate diagnostics and treatments are desperately lacking.
 
What we need:

• New diagnostic tools that are simple, reliable, and adapted for use in remote, resource-poor settings

• More potent drugs to shorten the length of treatment to only a few weeks and to address drug-resistant TB

• Drugs that do not negatively interact with AIDS drugs, for people co-infected with HIV

• Longer term, we need an effective vaccine to protect against the disease

What we are doing:

• Pushing for greater funding of TB research: given that around US$950 million needs to be invested annually in the development of new tools, but only just over $200 million was invested in 2005, there must be much greater financial commitment to TB by governments and international bodies.
• Calling for research community and regulatory agencies to explore ways to accelerate drug development. For instance through drug trials in drug resistant patients to get promising new drugs to people in need faster.
• Calling for clinical trials capacity to be expanded in developing countries: there are not enough TB patients in rich countries to allow new drugs to be suffiently tested.   
• Supporting a new model for R&D so that TB and other diseases that mostly affect the poor aren’t neglected as happens now as a result of the present profit driven system.
• Supporting ideas for new scientific collaborations to increase the discovery of promising molecules.
• Continuing to raise the alarm with governments and other international bodies about the inadequacy of the present tools to tackle TB  - both drug-sensitive and drug-resistant forms  - and press for TB to be established as a health priority worldwide.