Eradication in Sight? Overcoming Tuberculosis with Guy Marks

Professor Guy Marks AO FAHMS is a distinguished respiratory and public health physician and environmental epidemiologist. Currently serving as the President and interim Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union), he has led the Respiratory and Environmental Epidemiology group at the Woolcock Institute since 1997. His research primarily focuses on lung health, with particular emphasis on airway diseases, air pollution, and tuberculosis. Additionally, he is dedicated to capacity building in lung health research. In this episode, we delve into the essential factors for TB elimination, emphasizing the need for clinicians, researchers, and policymakers to focus on the infectious nature of TB. We explore the significance of large-scale active case finding, a strategy employed since the early 20th century, and discuss why targeted case-finding should be prioritized in middle- and low-burden countries where it proves most effective.Summary (Unfortunately not included in the audio) Despite extensive eradication efforts comparable to malaria and HIV, TB remains a persistent public health issue. Guy indicated that current metrics suggest we are not on track to meet the 2030-2035 global TB eradication targets. Professor Marks highlights the primary factors required for TB elimination, with emphasis that as clinicians, researchers, and policymakers, we need to centre our approach to TB eradication on the basis infectious nature of TB. Since its use in the early 20th century in Western countries, large-scale active case finding remains a primary strategy in the management of TB. Guy indicates that targeted case-finding should be reserved for middle and low TB burden countries where it is more effective.  Professor Mark's Vietnam-Based Research on TB Transmission shows that in high-burden TB countries: Most TB cases result from recent transmission, and are the largely responsible for driving the epidemic in these settings. Identifying and treating these recently diagnosed cases leads to a rapid reduction in TB incidence across the population.  Feasibility and cost remain as the prohibitive challenges for implementing molecular techniques widely in TB case identification. However, advances in radiographic technology are helping to bridge this gap, especially in high TB settings.  Professor Mark's suggests that the essential approach to achieving TB eradication will revolve around finding patients with TB and delivering efficient and effective healthcare.The Union World Conference on Lung Health 2024 is just a few days away starting on 12 November 2024 in Bali, Indonesia, but it is still not too late to register. Be sure to explore the comprehensive Programme, full of the latest scientific breakthroughs in tuberculosis and lung disease. If you cannot make it to Bali, registered delegates have online access to most sessions as they happen or can watch at leisure.