Paul Nunn, the WHO’s TB coordinator, says that these deadly strains have cropped up in certain European countries, too, though the reports have yet to be published. “If the health system of the world fails, the highly resistant strains will replace the old,” he adds. “We’ll see a worsening of the situation if nothing is done.” On the other hand, it may be only when the resistant strains become a major problem in rich countries that the profit-seeking pharmaceutical industry will take notice and pour real money into the development of potent new treatments.
Without effective drugs to combat the most resistant strains, doctors may have to revert to remedies from an earlier era. Udwadia recalls his first patient with untreatable TB. Twenty-six years old, she had spent the last five years trying a variety of anti-TB drugs, all of which had failed. As a last resort, she underwent a pneumonectomy, a high-risk medical procedure to remove a lung. The woman later died of complications from the surgery. The procedure had not been used on tuberculosis patients since the introduction of antibiotic treatments six decades ago.