Behind scenes with a deadly epidemic

Time Bomb due out next month

To TB experts, much of the ground covered by the book Time Bomb: The Global Epidemic of Multi-Drug Resistant Tuberculosis will be familiar territory. There’s the advent of HIV, the growth of antibiotic resistance, the chilling revelations about the Russian prison system, and the unresponsiveness of the pharmaceutical industry.

Familiar, too, will be many of the book’s personalities and much of its politics. There are Gates and Soros, Kochi and Khomenko — plus the ongoing struggle to wrest attention and resources from players by turns indifferent and hostile.

Right place at the right time

But it’s a safe bet that relatively few readers will have the author’s insider, eyewitness perspective. Lee Reichman, MD, MPH, director of the National Tuberculosis Center at the New Jersey Medical School in Newark (as well as an editorial adviser to this newsletter), has a canny knack for being in the right place at the right time when seismic events in the TB world happen — and, as often as not, for helping make them happen.

In 1986, for example, Reichman and colleagues published a seminal account of an unusual kind of TB that seemed to be turning up in patients with an as-yet-unexplained immune deficiency.

In the 1990s, as TB cases began mounting and deaths from multidrug-resistant tuberculosis (MDR-TB) grabbed headlines, Reichman was elected head of the American Lung Association,
a post he used as a bully pulpit to raise public awareness about TB and to get the funding spigots flowing.

When Alex Goldfarb, a former Russian dissident, persuaded wealthy financier George Soros to give millions to fight multidrug-resistant TB in Russia, Reichman was part of a team that brought back the first detailed reports of the country’s crumbling public health infrastructure. Later, he would go back to report on the shocking conditions inside the Russian gulag.

Never one to sit out a good fight, Reichman allied himself with a small band of feisty Harvard idealists who pricked the conscience of the World Health Organization, forcing it to agree to start treating MDR-TB victims in poor countries (who had previously been considered untreatable).

Next, when Russian chest physicians offered fierce resistance to new Western-style treatment strategies, Reichman befriended and supported one of the most powerful pro-Western TB researchers in the country.

Now that World Bank negotiations for a crucial public-health loan to Russia hang by a mere thread, Reichman is back again, taking the reader behind the scenes to the hot-tempered, high-level meetings.

The story of the rise of multidrug-resistant TB is one that needs urgently to be told, and it is hard to think of someone better equipped to tell it than Reichman.


[Editor’s note: Time Bomb by Lee Reichman (with Janice Hopkins Tanne), from McGraw-Hill publishers, will be in bookstores next month.]