NationStates Jolt Archive

OK, in Asia and the former Soviet Union new strains of TB are being found that are so resistant to antibiotics that the WHO considers them virtually untreatable. http://www.rte.ie/news/2006/0906/tb.html

The ethics question is this. If new antibiotics are developed that can beat this strain of TB, given the problems in some parts of the world with improper use of antibiotics causing TB to evolve resistance, should the distribution of the new drugs be limited to parts of the world where patients are more likely to complete the full course of treatment? If you do limit the availability people in Asia, Africa and the former Soviet Union die from treatable illness. If you don't you risk creating an even more resistant strain of TB that may spread far and wide before you can find another effective treatment.

MDR TB is really nothing new.The are new strains of the bacterium popping up every day much like the flu virus.(Rabbit Flu being the latest).If we have the technology to beat a certain strain ,even at the risk of it mutating into an even less treatable form we should do so.As the bacteria mutates so will our ability to treat it.Its an ongoing battle.The alternative would be to isolate the carriers and let nature take its course which lets face it is not a viable solution.
On a side note :I would be more concerned as to why the medical profession seems to be burying its head in the sand when it comes to something like MRSA which is occurances of which are drasticaly reduced with a simple thing like changing hygine habbits.

Hmmm.... Interesting Ethical Problem there DC...

Well... I suppose not sending it to the Former Soviets and Asia may be the lesser of two evils. Is a virus (not using this one in perticular) was to get a resistance, the drug would be useless and many more would die.

But the only true ethical option would be to ensure the sick in the Former Soviet Nations and Asia could receive full treatment. Everything else is leaving Humans to die.

I guess the rational course of action would be to attempt to minimize the amount of deaths that result from the mutated strain of TB or any other bacterium. If there is a method by which you can ensure that a person finishes his/her treatment, then the drugs should be administered. However, if there is a chance that the disease will become resistant to all drugs, and has the potential of becoming a worldwide epidemic, then the person who has the disease should be shot. Oh, and as for making new and better antibiotics -- you can't go down that path forever. The first tier antibiotics, for non-resistant diseases, hardly hurt a person at all. But the third-tier antibiotics, for heavily resistant diseases, are also toxic to those who take them. In general, the more resistant a bacterium, the more toxic the treatment.

not sending it to any country with advance pharmaceutical industry would be no solution. it would simply give them the greenlight to make their own generic versions of the drug. i'm not sure if its legal under international law to deny a drug to another nation, i kinda doubt it is.

Go with the only solution that works: napalm.

I wonder if these strains of TB are the result of evolution or actual engineering in the lab? The Soviet Union had a lot of biological weapons when it fell and a lot of them ended up just dumped or burned...it's possible that some of them might have escaped to infect people and transmit their resistance to other strains.

If it's lab engineered, you've probably got a pretty big problem on your hands.

not sending it to any country with advance pharmaceutical industry would be no solution. it would simply give them the greenlight to make their own generic versions of the drug. i'm not sure if its legal under international law to deny a drug to another nation, i kinda doubt it is.
Its not as if bacteria or virus respect international law or borders.If memory serves me NY city has a very high rate of West Nile Virus.If there is the possibility of it becoming a pandemic it should be treated.

I don't think we can go down the road of denying medical treatment to certain populations because they are "risky", especially when you consider the fact that people everywhere - even in major 1st world countries - will stop a run of antibiotics when they feel better, no matter how many times we tell them not to. The best we can do is be sure that the patient knows full well that they must complete the entire run, and then hope for patient compliance as close as possible to 100%.

Of course, as someone already pointed out, TB is highly unlikely to be a problem with most people anyways. The vast majority of people who are exposed to it never develop full-blown symptoms, because their immune systems are strong enough to isolate it and put the bacterium into a suspended state. Once exposed, you are never fully rid of the bacterium, but the disease will generally only be a problem if you have a weakened immune system for some other reason (ie. lack of nutrition, other illnesses, pregnancy, AIDS).