Track 2 Personal Response PDF

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Tuberculosis...

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Levelling the Playing Field Beating Tuberculosis

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Assessment Task: Personal Response (6%) CD Track: 2 (Molecular pathways open way for new, faster treatments of tuberculosis) Title: Levelling the Playing Field - Beating Tuberculosis Student Number: Word Count: 759

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Introduction to Tuberculosis: ‘Your Kiss of Affection, The Germ of Infection’ Tuberculosis is a lung disease which kills an average of about 1.5 million people a year. 10 million new cases emerge every year; of which 5% are cases involve drug-resistant tuberculosis. The high transmission rate of tuberculosis is attributed to the bacterium’s (mycobacterium tuberculosis) ability to survive in the air for several hours, thus making transmission by air its primary form of infection. The emergence of drug-resistant strains and costly and lengthy treatment times have increased the threat of tuberculosis. In an interview with Professor Greg Cook, who is leading the research on tuberculosis and development of drugs at the University of Otago, he discusses with Doctor Robyn Williams about the development of drugs which specifically target the enzymes responsible for metabolism within the tuberculosis bacterium. This drug can effectively and rapidly treat tuberculosis whilst having no effect on healthy human cells. The War Against Tuberculosis - Drug Resistance and Development Despite being a treatable disease, tuberculosis still kills millions in spite of modern medical advancements. Strains of drug resistant bacteria have lengthened treatment times by more than half. Professor Cook explains that while it takes about 6 months to treat a patient with a fully susceptible tuberculosis infection with short course chemotherapy, it takes about 12 to 24 months to treat a patient infected with a strain of drug-resistant tuberculosis. The increase in number of drug-resistant strains is largely attributed to incorrect drug use. In lesser-developed countries such as Myanmar where there is a lack of a social welfare system, antibiotic drug use is left uncontrolled. Patients are not educated properly on the importance of correct drug use, thereby leading to an increase in the number of cases involving relapses of drug-resistant strains. In more developed countries such as Australia and New Zealand, tuberculosis cases are few but therefore drug-resistant strains are more difficult to identify and diagnose. About 80% of tuberculosis cases in Australia occur in people who are not born locally, making tuberculosis an internationally transmitted disease. In one case, it took 60 days for doctors to diagnose an international student from Myanmar with tuberculosis. Recently, research into molecular pathways in the bacterial cell has revealed a new vulnerability in bacterial cell metabolism. Bedaquiline is a new ‘uncoupler’ drug developed by Johnson & Johnson which specifically targets the enzymes in the tuberculosis bacterium. It is similar in function to a compound called ‘dinitrophenol’ as it uncouples metabolic reactions therefore eventually leading to a drastic decrease in bacterial metabolism. However, 2

unlike ‘dinitrophenol’, Bedaquiline has no effect on the human mitochondria. Rather, Bedaquiline specifically binds to bacterial enzymes. Being a fast-acting drug, Bedaquiline can shorten treatment time of TB from 24 months to just 6 months, thereby reducing cost of treatment as well. With lowered treatment time, patients are more easily able to complete their course of medication, lowering the risk of an emergence of a resistant strain of tuberculosis. The Dawn of a Disease-Free Future This topic sparked my interest as I believe that our society is in a current rat race with diseases which have presented us with numerous pandemics and epidemics from the bubonic plague in the mid-1300s to the current Ebola epidemic of the 21st century. Professor Cook mentions that fast-acting drugs and better methods of diagnosis must be developed especially in third-world countries in order to better detect active and latent forms of the TB bacterium before it can spread. However, he believes that while diagnostics may be important, the main focus should shift towards developing better drugs that can treat effectively and lower the overall number of infected people. I oppose to this point slightly, in that there is only so much advancements in medicine and the development of new drugs can do. A viral mutation can occur in a comparatively shorter timespan than a new vaccine can be developed. Additionally, when a doctor or pharmacist explains a certain prescribed medication to a patient, how often does the patient really listen? It is common in many people to only care about how fast he or she can return to a normal state of life, whilst shunning the dangers of incorrect drug use. The change in our approach towards diseases such as tuberculosis must start from each individual’s mindset. This can only done with the proper education and instillment of the importance of correct drug use. In conclusion, if there is any hope in ever achieving the ultimate goal of a disease-free future, the change must first come from within each individual.

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