Warm weather brings crop of conferences

Hot topics spark TB congress

It’s summer. And as surely as songbirds migrate, flowers open, and vegetable gardens are planted, TB conferences bloom across the land. In Atlanta in May, 24,000 pulmonary and critical-care physicians and researchers converged for the annual American Thoracic Conference. Also, the National TB Controllers Association (NTCA) was scheduled to hold its annual workshop June 18-19 in Fredericksburg, VA. This year’s NTCA get-together centered on performance improvement.

One of the starchier-sounding entries on the confab calendar was the 4th World Congress on Tuberculosis, slated for June 3-5 in Washington, DC, which promised to bring almost everyone in TB together to talk about almost everything.

Far from dull, the 4th TB World Congress (the 3rd took place back in 1992) was due to feature some impassioned, even fiery sessions, says Ann Ginsberg, MD, PhD, chief of the respiratory diseases branch at the National Institute of Allergies and Infectious Diseases in Bethesda, MD, and a principal organizer of the event. Sessions that seemed sure to throw sparks included talks on multidrug-resistant (MDR) TB, the global epidemic of pediatric TB, and the HIV-TB co-epidemic.

Pediatric TB and the co-epidemic

Jeff Starke, MD, deputy chief of pediatrics at Houston’s Ben Taub Hospital, was scheduled to tackle pediatric TB. "That’s a problem that’s really been ignored," Ginsberg notes. "No one’s paid much attention [worldwide] to the epidemiology, since the accepted dogma is that kids don’t transmit the disease." Starke, an impassioned orator when it comes to his specialty, was expected to deliver an "eye-opening" report on the subject, Ginsberg says.

As for MDR-TB, it looked as if the "small-envelope" crowd — those who perceive TB resources as limited and who urge pragmatic approaches to global TB control — were due to slug it out again with the "big envelope" opposition, who contend that new paradigms, not more penny-pinching, are what’s needed to meet the costly challenge of global MDR-TB.

Then there were sessions on the co-epidemics of HIV and TB, remarkable partly because "there hasn’t been very much discussion on the co-epidemic, and I’m afraid the world will pay for our collective lack of attention and effort," Ginsberg says. Talks included how to control TB in a high-prevalence HIV setting, how to use antiretroviral therapy (ART) to staunch the co-epidemic, and the potential for using a DOTS infrastructure to deliver ART.

More broadly, the congress would bring together experts and researchers from disparate areas "who need to hear from each other," Ginsberg says. "It’s important to get all these people into the same room — the laboratory researchers, policy-makers, operational people, field workers, and funders — so they can inform each others’ thinking," she adds. "That doesn’t happen nearly as often as it should in TB. For example, people developing vaccines need to hear from those in the field about what kinds of products can feasibly be delivered."