The old battle between the human species and Koch’s bacillae. Can one dream of eradicating tuberculosis?

Abstract

This article analyses the complexity of the age-old battle that the human species has been waging for millions of years against Mycobacterium tuberculosis. We review all of the knowledge available about this disease, and the most important future developments, in order to reach the conclusion that it is indeed possible to dream of eradicating this disease that has caused such harm to humanity. In spite of the human species possessing sufficient knowledge to win the battle against Mycobacterium tuberculosis, important conditioning factors, above all social in character (poverty, immigration, HIV, MDR), are favouring the bacteria in this war. And, in spite of suitably applying all of the positive knowledge acquired for the control of TB (detection and cure of cases, chemoprofilaxis, BCG vaccination, etc.), it will still take several centuries to achieve its eradication. Only by discovering a vaccine that is 100% efficient, or the discovery of new anti-microbial associations that could cure the disease in no longer than 15 days, could accelerate this advance towards its eradication. But, unfortunately, there are no reasons allowing us to dream that either of these two possibilities can be fulfilled in the next 10 to 20 years. Therefore, the dream of eradicating TB is a very old dream, but one that unfortunately remains very distant.