Tuberculosis (TB) is often seen as a disease of the past. Before the advent of antibiotics, the treatment for TB was bed rest, fresh air and good food – but only if you were lucky enough to afford a sanatorium. Without drugs, many people died a slow and unpleasant death, suffering from night sweats, weight loss and terrible coughing fits (with blood).
Nowadays, “consumption” has an air of tragic romance about it, often being associated with the slow wasting death of beautiful, young women. Perhaps because of some famous works of art depicting the suffering caused by TB, and its association with poverty.
Two of my favorite operas have leading ladies who succumb to consumption. In La Boheme, the association of TB with poverty is made clear when Mimi, the seamstress, becomes fatally ill while living in poor lodgings, likely with bad nutrition and no heating. Mimi shows the classic symptoms resulting from a lack of treatment, which leads to her quiet death in a garret in Paris. Colline’s efforts to sell his overcoat to buy medicine is doubly sad, as it comes too late and would have been ineffective, as there were no antibiotics for TB at that time.
In contrast, in La Traviata, our leading lady Violetta is a courtesan with resources, who is celebrating recovery from an illness at the start of the opera, at which point she sets out on a love affair with Alfredo. However, during the opera, it becomes apparent that her illness is not over as it reemerges. This shows us another side of TB, as a chronic and debilitating disease with a slow progression. In the absence of drugs, Violetta is no more fortunate than Mimi, and she too dies from TB.
Both these operas were set in the 19th century when TB was rife in Europe. This World TB Day, we need to stop and think about TB in the 21st Century. TB deaths remain above 1 million, and last year, TB had the dubious honor of being the biggest killer from infectious disease. TB is a prolonged and painful disease, with serious consequences for sufferers, even if they get the drugs they need.
Yes, we are fortunate to have drugs to treat TB now, but they are not good enough. That is why we at IDRI are working to find and develop new drugs for TB. Our mission is to make a difference to people’s health and lives – and by doing so, to save all those Mimis and Violettas and the countless others suffering from diseases of poverty.