Nolen: The first Tuberculosis patient I sat with Nairobi was a man who had extensive drug-resistant tuberculosis or XDR-TB-TB-vomited there is a very delicate chance that the only drugs we know will really cure him. We are out of choices. And he had come to that day, as he had very optimistic every day for a week, to get his delamanid. And it was out of stock.
Green: Oh my God.
Nolen: And I was just like, “This is terrible for you, barrack. This is terrible for your wife and for your five children.” Everyone had been shown and so far everyone was without tuberculosis. But like so many people, he had gone bankrupt by his infection. He had to send his wife and his children back to the village because he did not have the luxury of holding them in the city.
The XDR-TB is scary for him both for his family and for all the people who are interested in him. But it is also scary for the rest, for man to go to this clinic daily and then return to this apartment building, where he lives full of Jowl with 500 other people, with tuberculosis he can no longer face. This is very, very bad for him. But it is also very, very bad for everyone else.
Green: Yes. I think it is important to understand that this is a tragedy on an individual level, at hundreds of thousands of individual levels, but it is also – I don’t know how I feel about the phrase “global health” sometimes, because I think it sounds like we are talking about health in poor communities. The truth is that this is a crisis for human health, for people everywhere. A person was exposed to an antibiotic we hope to work. And then, due to a stock caused by the United States government, their contamination now has the opportunity to develop resistance to this medicine, in addition to developing resistance to so many other medicines.
We could very easily come up with a situation where we do not have tools to combat tuberculosis. And that leads us to the early 20th century. It leads us back when my great uncle died of tuberculosis when he was 29 years old. He worked as a port in Alabama power and light. His dad was a doctor and there was absolutely nothing that his dad or someone else could do to save his life.
Nolen: Does anyone in the US get it anymore?
Green: Yes, we will have about 10,000 cases of active tuberculosis in the United States this year. In fact, the rate of tuberculosis in the US goes up.
Nolen: Why?
Green: We downgrade public healthcare systems, and we also do a terrible job to get treatment in places where treatment is required.
Nolen: Earlier you said that we know exactly how to live in a world without tuberculosis, but we choose not to do it. Why do you think we are so pleased to live in this world?