The Worlds Deadliest Infectious Disease is About to get Worse
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https://www.theatlantic.com/health/archive/2025/03/tuberculosis-death-usaid-trump/682062/
Mycobacterium tuberculosis is a near-perfect predator. In 1882, Robert Koch, the physician who discovered the microbe, told a room full of scientists that it caused one in seven of all deaths. In 2023, after a brief hiatus, tuberculosis regained from COVID its status as the world’s deadliest infectious disease—a title it has held for most of what we know of human history.
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The cure for TB—roughly half a year on antibiotics—has existed since the 1950s, and works for most patients. Yet, in the decades since, more than 100 million people have died of tuberculosis because the drugs are not widely available in many parts of the world. The most proximate cause of contemporary tuberculosis deaths is not M. tuberculosis, but Homo sapiens. Now, as the Trump administration decimates foreign-aid programs, the U.S. is both making survival less likely for people with TB and risking the disease becoming far more treatment-resistant. After decades of improvement, we could return to something more like the world before the cure.
Anyone can get tuberculosis—in fact, a quarter of all humans living now, including an estimated 13 million Americans, have been infected with the bacterium, which spreads through coughs, sneezes, and breaths. Most will only ever have a latent form of the infection, in which infection-fighting white blood cells envelop the bacteria so it cannot wreak havoc on the body. But in 5 to 10 percent of infections, the immune system can’t produce enough white blood cells to surround the invader. M. tuberculosis explodes outward, and active disease begins.
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But there were almost 1MM/year in the 1990's.
Crazy Bill Gates and his anti malaria work.
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https://www.nationalgeographic.com/animals/article/african-giant-pouched-hero-rats-stop-tb-landmines
Until recently, Carolina worked Monday through Friday, with weekends off.
At her retirement this past November, colleagues lined up to applaud her and celebrate over cake. In her seven-year career, she had detected more than 3,000 cases of tuberculosis that health clinics had missed and, as a result, likely spared more than 30,000 other people from infection.
But she's not exactly your typical employee. Carolina is an African giant pouched rat who can screen 100 sputum (i.e phlegm) samples for tuberculosis in 20 minutes—much faster than a human, who takes four days to process the same amount of information with a microscope. And she’s part of a cohort of 40 rats belonging to nonprofit APOPO who are helping to combat the tuberculosis epidemic in Tanzania and Ethiopia.
“Everybody’s first impression is that the rats are our enemies,” Tefera Agizew, a physician and APOPO’s head of tuberculosis, says of the animals’ reputation in Africa and beyond. “Once they see how they function, they fall in love with them.”
African giant pouched rats are not your typical New York City–style rodent. They’re calm, easier to train than some dogs, and able to work up to seven or eight years (they live eight to 10 years in captivity). Their body alone is generally longer than a 13-inch MacBook Air—and their tail is equally as long, if not longer. (A New York City rat is only about 16 inches, nose to tail.) A giant pouched rat’s sense of smell is so strong that they could conceivably detect half a drop of chlorine in a space the size of 20 Olympic-sized swimming pools, says APOPO’s head of training Cindy Fast, a behavioral neuroscientist who coaches the rodents.
