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March 4, 1992

Do Worldwide Outbreaks Mean Tuberculosis Again Becomes 'Captain of All These Men of Death'?

JAMA. 1992;267(9):1174-1175. doi:10.1001/jama.1992.03480090016004

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THE ADMINISTRATION, public health community, and Congress all are trying to head off the spread of multidrug-resistant tuberculosis in the United States. Many reports of the resistant form of the organism have been linked with those who are infected with the human immunodeficiency virus (HIV).

As the problem grows, President George Bush is nearly doubling the request for funds for tuberculosis elimination to $40 million this year. In Congress, Sen Edward Kennedy (D, Mass) is requesting funds to study issues raised by the occurrence of this resistant form and its association with HIV.

Drug-resistant tuberculosis also is being reported around the world, especially in developing countries, says Barry Bloom, PhD, Albert Einstein College of Medicine, New York, NY. Resistance has emerged, he says, because antituberculosis drugs were freely distributed in some countries without controls over their use.

System Failure?  In the United States in the years prior to 1984, about