The Return of the White Plague: Global Poverty and the New Tuberculosis - Hardcover

Hardcover

ISBN 10: 1859846696 ISBN 13: 9781859846698

Publisher: Verso, 2003

Synopsis

The dramatic increase since the 1980s in the global prevalence of tuberculosis, a disease destined as recently as thirty years ago for complete eradication, is a story of medical failure. A pandemic whose geography defies simple categorization, it ranges from schools in the UK to prisons in Russia, from refugee camps in central Africa to affluent suburbs in North America. The ‘new’ tuberculosis is derived from a combination of different developments such as collapsing health-care services, shifting patterns of poverty and inequality, the spread of HIV, and the emergence of virulent drug-resistant strains.

This collection provides an international survey of current thought on the spread and control of tuberculosis, covering historical, social, political, and medical aspects. While the contributors may differ in their opinions over specific treatments or research methodology, all are agreed on the overriding thesis of the book – that the resurgence of disease is one of the most telling indictments of the failure of global political and economic institutions to improve the lives of ordinary people.

About this title

About the Author:

Matthew Gandy teaches geography at University College London and has published widely on urban and environmental issues.

Alimuddin Zumla is the Professor of Infectious Diseases and International Health at the Royal Free and University College Medical School.

From The New England Journal of Medicine:

Since the World Health Organization declared tuberculosis a global emergency in 1993, its resurgence has become the source of several recent publications. Gandy and Zumla have assembled a prestigious and knowledgeable group of authors for an updated account that appropriately goes beyond the usual biomedical assessment of the current global situation. As suggested by the title and an introductory quotation provided by the editors, Rene and Jean Dubos had already drawn attention to the social and economic aspects of tuberculosis 51 years earlier in The White Plague: Tuberculosis, Man and Society (Camden, N.J.: Rutgers University Press, 1952). There is special emphasis in the book on the social and economic factors that have influenced the persistence of tuberculosis in many parts of the world. Unfortunately, as the editors acknowledge, the limitations of the available data make it "difficult to disentangle fully the relationship" and interactions among socioeconomic status, racial differences, sex, wars, the pandemic of human immunodeficiency virus (HIV) infection, multidrug-resistant tuberculosis, and transmission of the disease in prisons. The reviews of these topics are fairly balanced and thorough, with appropriate citations and references. The broad overview of the book challenges the prevailing notion that the global efforts to control tuberculosis and the attribution of credit to directly observed therapy have been the principal contributors to the reduction of tuberculosis in New York City and other places. In putting forth this challenge, the authors may provoke controversy. Ultimately, it becomes clear that both causal inference about and potential solutions to the problem of tuberculosis involve many factors. Some of the chapters outline the unmet humanitarian needs of persons with tuberculosis that involve race and ethnic background, "gender-sensitive" approaches to care, and immigration from countries where tuberculosis is prevalent. Instead of blindly siding with the good intentions that accompany much-needed reforms in the health sector, authors Harries, Hargreaves, and Zumla, who contribute a chapter on tuberculosis and HIV infection in sub-Saharan Africa, acknowledge the potentially drastic consequences of the "rapid dismantling of disease control programmes." Other formidable challenges posed by HIV and multiple-drug resistance are adequately covered, as are potential solutions that emphasize the need to pay attention to neglected areas such as the primary prevention of tuberculosis. Authors also emphasize the importance of operational interdisciplinary research and the need for new drugs and safe and effective vaccines. The call for the alleviation of poverty and the promotion of ethical and human rights is refreshing, and it is consistent with the control of tuberculosis in high-burden countries as integral to economic development. Both the editors and the chapter authors appropriately identify the need to go increasingly beyond humanitarian declarations into action and implementation. Doing so is a crucial component of a comprehensive and responsive approach to the global crisis of tuberculosis. The Return of the White Plague is a commendable treatise of much interest to socially minded health care practitioners. Kenneth G. Castro, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About this edition

• Publisher: Verso
• Publication date: 2003
• ISBN 10: 1859846696
• ISBN 13: 9781859846698
• Binding: Hardcover
• Edition number: 1
• Number of pages: 336
• Editor: Gandy Matthew, Zumla Alimuddin