Het tuberculosefront

BERLIJN – Dit is een goed decennium geweest voor de strijd tegen de tuberculose. We zullen waarschijnlijk het Millennium Development Goal van de Verenigde Naties halen om de verspreiding van en de sterfte aan tuberculose in 2015 met de helft te verminderen ten opzichte van het niveau van 1990. Minstens een dozijn nieuwe vaccins en geneesmiddelen bevinden zich in de fase van klinische proefnemingen, en de Wereldgezondheidsorganisatie heeft een nieuwe diagnostische test, genaamd GeneXpert, goedgekeurd.

Deze vooruitgang is des te belangrijker, gezien de zelfgenoegzaamheid die heeft geleid tot een volledige stilstand in het onderzoek naar en de ontwikkeling van nieuwe tuberculose-behandelingen aan het eind van de 20ste eeuw. De middelen tegen tuberculose die momenteel in gebruik zijn, werden tussen 1950 en 1970 ontwikkeld. Het Bacille Calmette–Guérin (BCG)-vaccin is bijna honderd jaar oud, terwijl de meest gebruikte diagnostische test, de microscopische ontdekking van bacillen in sputum, al 130 jaar geleden is ontwikkeld.

Geen wonder dat de werkzaamheid van deze middelen is verminderd. Het huidige vaccin voorkomt ernstige tuberculose bij kinderen, maar niet de meest voorkomende longtuberculose in alle leeftijdsgroepen. De microscopische test levert in bijna de helft van de gevallen foutieve resultaten op.

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