TB or not TB: that is still the question

One hundred and twenty five years ago, the discoverer of the tubercle bacillus and mdash;the legendary German investigator Robert Koch and mdash;unveiled his cure for tuberculosis. Unfortunately, the much-heralded and ldquo;Koch's lymph and rdquo; (or Old Tuberculin) failed to cure TB. Dr Arthur Conan Doyle (who would later be celebrated as the creator of Sherlock Holmes) had been skeptical about the new cure from the start, but foresaw diagnostic possibilities for Old Tuberculin. It had taken Koch a whole year of focused effort and mdash;and as lore has it and mdash;serendipity, to see TB bacilli on a slide forgotten on a warm stove. But a hundred years later, at the turn of the millennium, TB was still being diagnosed using primitive tools: a microscope to detect active disease; a ball-pen, a measuring tape and a drop of the Purified Protein Derivative of Old Tuberculin to detect TB infection. It is a tragedy of the times, no less, that the benefits of the enormous advances in medical science have not translated into improvements in TB diagnosis or treatment and mdash;until very lately. TB is largely perceived as a problem of the third world, and the fiscal market in the third world simply does not hold enough lucre to attract the interest of the pharmaceutical industry for TB drug research.