TB Historical Timeline
1851 – one person in four killed by TB in
1854 – santorium treatment began.
Treatment commenced with 24 hours confinement to their bed, with no activity
allowed at all. Slowly periods of increasing activity were introduced. Fresh air
was advised for patients at all times and in all weathers – many former
patients of sanatoria remember being snowed on when their bed had been wheeled
out into the open air – some even slept like this! A healthy diet was also
promoted.
1882 –
Robert Koch identifies that TB is caused by an organism, Mycobacterium tuberculosis.
1904 – the
first charity seal to fundraise for tuberculosis patients introduced in
1920 – the first human trials of the vaccine Bacille
Calmette Guérin (BCG), an
attenuated version of Mycobaterium bovis (Bovine
TB).
1935 –
Pasteurisation of milk introduced in
1944 – Drs Schatz, Bugie
and Waksman announced the discovery of a drug called
'Streptomycin' and the first patient to be successfully treated with the drug.
1952 - Drs Robizek
and Selikoff at
1953 – BCG vaccination
introduced in secondary schools in the UK, after the introduction of similar programmes
in France and Scandinavia following a survey of 50,000 children which
showed an 80% reduction in infection rate. At the time, those most at risk of
TB in the
1960 - Dr John Crofton, a TB
expert at the University of Edinburgh, (and now Honorary President of TB Alert)
proposed that a combination of drugs, Streptomycin, PAS and Isoniazid
made TB completely curable and he declared "all out war" to conquer
the disease. His proposals included the pasteurization of milk, tuberculin
testing of cattle, BCG vaccinations of whole populations, mass radiography for
the early detection of disease, triple therapy for every infected patient,
isolation of the infectious until no longer so and reduction in household
overcrowding. All this would hopefully be accompanied by a general improvement
in the standard of living.
1970 – first
outbreak of drug resistant TB in
1987 – TB figures in
1993 – the
World Health Organisation declares TB a global emergency, estimating that one
third of the world’s population (2 billion people) is latently infected with TB
and 7-8 million cases of active TB occur each year. TB is killing more people
than any previous year in history.
Directly Observed Treatment, Short-course (DOTS), locally
known as
the Revised National
Tuberculosis Control Programme (RNTCP), introduced in
1995 – the
first recorded outbreak of MDR-TB at a
1999 -TB Alert,
the
2004 – National Action Plan, “Stopping Tuberculosis in
Nelson Mandela called for
stepped up efforts to control tuberculosis, saying the fight against AIDS is
incomplete without targeting the lung disease. “TB is too often a death
sentence for people with AIDS. It does not have to be this way,” said Mandela,
who successfully battled tuberculosis while in prison during the apartheid era.
Tuberculosis is one of the
most common diseases that attacks AIDS patients after
their immune system has been destroyed by the virus. Many people with HIV die
prematurely from TB because they are not treated in time. “The world has made
defeating AIDS a top priority. This is a blessing, but TB remains ignored,”
said Mandela, at the International AIDS Conference in
He noted that mankind had
known the cure for TB for more than 50 years. But what had been missing was the
“will and the resources to quickly diagnose people with TB and get them the
treatment they need. We can’t fight AIDS unless we do much more to fight TB as
well.”
2005 – Withdrawal of the BCG
school vaccination programme in the
The World Health
Organization (WHO) Regional Committee for Africa comprising health ministers
from 46 Member States declared tuberculosis an emergency in the African region
- a response to an epidemic that has more than quadrupled the annual number of
new TB cases in most African countries since 1990 and is continuing to rise
across the continent, killing more than half a million people every year.
2006
January: The Stop TB Partnership
launched its Action Plan to Stop Tuberculosis 2006-2015.
The Plan aims to cut deaths
from TB in half in the next ten years and provide treatment for 50 million
people. It requires $56 billion to carry out its aims – less than $1 per day of
healthy life gained, with 14 million lives saved by 2015. At the launch of the
Plan, which took place at the World Economic Form in Davos,
Bill Gates pledged to triple investment through the Gates Foundation, taking
the amount committed from $300 million to $900 million. The total funding gap
to carry out the Global Plan is estimated at $31 billion.
This is the second Global
Plan from the Stop TB Partnership. The first, covering 2001-2005, led to the
number of patients treated in DOTS programmes being doubled over 5 years, from
2 million in 2000 to 4 million in 2004, as well as a major improvement in case
detection – both India and China which between them have 35% of the world’s TB
cases are now close to the target of 70%. The new plan, based on WHO’s new Stop Tuberculosis strategy, builds on the first in
that it seeks to deliver more on the ground and gives greater emphasis to the
issues of HIV/TB co-infection and MDR TB through adapting the use of DOTS.
The barriers to stopping the
TB are complex and vast and the Plan recognises that these need to be
identified and removed. As well as increasing the accessibility of quality
anti-TB drugs, the social burdens of the disease for patients also need to be
addressed. Equally, health services need to be adequately resourced and
committed to eliminating TB. More effective tools are also an aim of the Plan,
with targets of diagnostic tests at the point of care by 2012, a safe,
effective and affordable vaccine by 2015 and a treatment regime of 1-2 months
shortly after 2015.
US-Danish non-profit
initiative, the Aeras Global TB Vaccine Foundation,
started the first laboratory dedicated to improving the TB vaccine. The current
BCG vaccine was invented over 80 years ago and is frequently ineffective,
especially in people with lowered immunity. Aeras has
received a $82.9 million grant from the Bill and
Melinda Gates Foundation for its work.
March: The
National Institute for Clinical Excellence (NICE) publishes “Guidelines for the
clinical diagnosis and management of tuberculosis, and measures for its
prevention and control” in the