The tuberculosis in 2020: challenges and opportunities

Abstract

Despite the progress achieved in recent decades, tuberculosis continues to be a major public health problem in wide areas of the world geography, and caused more than 1.6 million deaths in 2017. The eruption of cases with multidrug-resistant tuberculosis and extremely resistant hinders its healing and its progressive eradication. Fortunately, in the past few years, molecular techniques capable of diagnosing the disease in a few hours have been introduced, also detecting genetic mutations that encode resistance to the most active drugs in its cure. With the incorporation of bedaquiline and delamanide, we count on new shorter, more effective and less toxic treatment schemes for resistant cases. The future of the fight against tuberculosis must be based on clinical suspicion in the most vulnerable groups (elderly, immunosuppressed and immigrants), an accurate and early diagnosis, a short treatment with oral drugs and the inclusion of solidarity socioeconomic strategies that improve the situation of the most vulnerable countries and groups.