This week on the radio 4 appeal of the week, Jeremy Paxman was appealing for funds for  TB Alert.

I had heard snippets of news before about the rise in cases of TB but had not realised how the incidence had escalated. The facts were quite horrifying.  The numbers of cases have been rising since 1987, they have doubled in London and there are many cases which remain undiagnosed, either through ignorance or fear of the stigma attached to the disease. More people are diagnosed with TB than with HIV.

In the UK alone 400 die every year. It is estimated that 1/3 of the world is infected. Every year 10 million develop active TB, 2 million die, every minute 2 children die!  40% have no access to treatment, either because there are no clinics or they do not know of the existence  of TB.

I suppose I was like most people and thought this was a disease of the past. In my childhood we only too aware of it. My maternal grandfather and three of  his sons had died of TB, or consumption as it was then known.

When I was at school we were all taken, form by form, to the mass radiography unit every year.  There they took a small chest Xray and,  if anything unusual was detected, we were recalled for a full sized Xray and further investigation if necessary and every year there would be someone sent off to Newstead sanitorium.  At the sanitarium they would be treated with fresh air, wholesome food and rest. Their lungs may have been collapsed, (one at a time of course!)  to give the infected lung a chance of repairing itself, and that was all they could do until the advent of streptomycin. Many of those affected were away from school for over a year.

 Before the NHS began, there was very little treatment for ordinary people, but the rich trailed around Europe to the clinics in the mountains.  

Some of us built up a natural immunity over the years, as shown when the Mantoux test was developed and the BCG vaccine became available.

Over the years, as treatment improved, we have become complacent about it. Modern people are not so aware of the symptoms, the mass xray clinics which were easilyaccessible are gone, most of the sanataria have closed, and there are no longer notices forbidding spitting in public places!

  We began to see a few more cases in the 60s-70s, when I worked  for a GP, due to the increase in global mobility, but they still had the mass Xray units, and once the disease was diagnosed it could be treated quite easily. Now I suppose, like many baccilli and bacteria the tubercular baccillus has become immune to the antibiotic.

TB Alert is trying to address the problem by promoting awareness of the increasing  incidence of the disease, taking away the stigma, training local people, but most of all tackling poverty (as the incidence is so much higher in the poverty stricken areas).

This should be enough to answer those who question giving Overseas aid. As many of us travel worldwide now,  illnesses from these far flung places are transferred more easily from one country to another, so it makes sense, if only from the selfishness of self preservation, to do all we can to alleviate the conditions where the diseases thrive. otherwise we are all at risk.

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