typically concentrated to where they are most needed—poses significant challenges. Multidrug regimens administered for an appropriate duration will be essential until new methods of preventing and curing TB are developed. The acquisition of drug resistance in the microbes needs to be slowed through prudent but equitable access to new tools, from rapid diagnostics to novel agents effective against M.tb., and through new approaches that move safe and effective care to the communities in which patients and their families live and work. At the moment, many TB programs are not sufficiently resourced to catch up with the microbe.

Partnerships will be essential to deal with these and other complex health problems. Cooperation should be south–south as well as south–north, Farmer said, but also with those most affected by the disease, the patients and their families. Collaborations among universities, the public sector, and community health workers have proven their effectiveness in diverse settings when a patient-focused approach is embraced. When the best diagnostics and therapeutics are available as part of an equitable and humane delivery platform, many lives can be saved and many new infections averted.

The BRICS countries have, or are mustering, the technological and financial resources to enable innovation. Building an equitable and humane delivery platform will require further resources. “A lot of the answers for this global challenge are likely to come from China and from some of other countries we are calling the BRICS countries,” Farmer predicted. “I am confident that these problems, including drug-resistant TB and rising health disparities, must and will be addressed here, and that the rest of the world will learn.”

TB can be addressed effectively, Farmer concluded, only by “significant and sustained investments in protecting public health, not just in one corner of the global economy, but everywhere.”



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