At a time of political tensions between the United States and North Korea, researchers at Stanford's medical school have been able to reach across the divide, creating a first-ever partnership with the North Korean government to help fight tuberculosis in the Asian nation.
North Korea is believed to have among the highest incidence of TB in the world outside of sub-Saharan Africa, with a rate of 345 cases per 100,000 people, the researchers write (registration required) in today's issue of Science. Moreover, the country is thought to have a substantial problem with multi-drug resistance (MDR), which can threaten global control of the disease, the researchers say.
Over the last two years, epidemiologist Sharon Perry, PhD, professor of medicine Gary Schoolnik, MD, and a team of microbiologists from Stanford and Bay Area public health programs have made several visits to North Korea to establish a modern TB laboratory and train public health officials so they can accurately diagnose multi-drug resistant disease and then treat patients accordingly. The work has been done in collaboration with the Christian Friends of Korea, with support from the nonprofit Nuclear Threat Initiative.
Why is this so important?
Beyond the pressing humanitarian issues, the fact is that TB is a significant global threat. The bacteria is not only highly infectious but also deadly: Half of those who go untreated die, and because of their exposures to others, they may spawn between 10 and 20 new cases, the researchers note. The bacteria doesn't respect borders; for instance, multi-drug resistant strains that thrived in Russia following the fall of the Soviet Union have turned up in Western Europe, the Middle East and South Africa, according to the researchers. And:
The modern MDR-TB epidemic reminds us that the loss of TB control leaves costly legacies, for which the world community is ultimately responsible. As discussions continue about how to deal with North Korea, it is important to remember that decisions made in a narrow security arena can have far-reaching global health consequences. Efforts such as the TB laboratory project are evidence that engagements based on mutual health interests are not only possible, but also crucial to sustain.