XDR-TB: Photographer Brings Emerging Disease Into Focus · Global Voices
Juhie Bhatia

In 2007 renowned war photographer and photojournalist James Nachtwey received a TED Prize, granting him $100,000 and one wish to change the world. Nachtwey's wish was to share a vital story in an innovative way using news photography. Last week his wish came true with the unveiling of his photos, which show the global impact of XDR-TB (extensively drug-resistant tuberculosis), and the launch of a multimedia public health campaign.
XDR-TB was brought to the world's attention in 2006, after it was identified in KwaZulu-Natal, South Africa. It is a mutation of tuberculosis (TB), a contagious bacterial disease that usually affects the lungs. TB, which spreads through the air, is a major cause of illness and death worldwide, particularly in Asia and Africa. In 2006 there were 9.2 million new cases of TB and 1.7 million deaths from the disease.
TB is treatable, but inadequate treatment can lead to the emergence of drug-resistant strains of the disease, such as XDR-TB. This type of TB is resistant to all of the most effective anti-TB drugs, severely limiting treatment options for people with XDR-TB and resulting in a much higher death rate. This video provides an overview of TB and XDR-TB. It's unknown how widespread XDR-TB is, but it's estimated that 25,000 to 30,000 new cases surface every year, and XDR-TB has been found in 49 counties around the world. Scientists are calling  XDR-TB a serious emerging threat to public health.
Ridzuan, blogging on Ridz.sg, expresses dismay over the unnecessary emergence of XDR-TB:
“There is a problem when a disease that’s both preventable and curable is allowed to mutate to become a strain that’s extremely resistant to the drugs that we use today.”
Nachtwey traveled to countries such as India, Cambodia, South Africa, and Lesotho to put faces to this problem. His photos and the accompanying XDR-TB Web site were launched on October 3. This short video shows 37 of his black and white photos, revealing XDR-TB's terrible impact.
The release of this video and the unveiling of Nachtwey's photos, have created a buzz among the art and public health communities. tunneling thru’ talks about the emotional impact of his photos.
“I don’t know anyone who is suffering from it [XDR-TB], but that is no excuse for me to flip through an album or site and walk away unaffected. There is no personal angle to this. Just a need to share and see if it makes a difference. The pictures within spoke more emotions than I knew I was capable of.”
Bloggers are also discussing how Nachtwey's images are motivation to take action, and the power of his photos to create change. Luke Freeman, blogging on A Shoe Box Full of Pictures, says:
“The photography is powerful, yet the purpose behind the images gives this project even more meaning. These are not just images. Work like this will change the world. Photography, coupled with a selfless, heart-felt response has the power to affect change.”
Since TB is a major cause of death among people with HIV/AIDS, especially in sub-Saharan Africa, concerns also exist about XDR-TB's potential impact on those who are HIV positive. There were an estimated 710,000 HIV positive TB patients globally in 2006. Journal of the Plague Years points out that despite this, only one percent of those diagnosed with HIV are tested for TB worldwide, and that TB testing must become routine for HIV positive people.
“Doctors, scientists and public health experts are warning that a worldwide pandemic of extremely drug resistant tuberculosis will be the next big ‘surprise’ to emanate from the AIDS epidemic, if, as we move forward we are not informed by our look at the past.”
In My Heart's in Accra…, Ethan Zuckerman, a co-founder of Global Voices Online, discusses other steps needed to stop XDR-TB.
“Nachtwey’s intervention is a timely one – the ways to prevent XDR-TB from becoming a pervasive global threat have to do with strengthening healthcare systems in vulnerable nations. If hospitals and community health organizations can diagnose TB early and ensure compliance with treatment, the disease shouldn’t progress to multiple drug resistance. But improving developing world hospitals is a difficult and expensive task. Eliminating pharmaceutical fakes may be even more difficult. Fake prescription drugs are extremely common in developing nations.”
Sproutingforth, blogging on Urban Sprout, adds that the lack of funding is a major issue.
“Reversing the TB epidemic is a political issue as much as it is a health issue. The World Health Organization estimates that it will cost approximately $6.7 billion annually to reverse the TB epidemic. Currently, only slightly more than half of that is projected to be available at current funding levels. This gap is costing millions of lives.”
Nachtwey’s photographs will be on display throughout October in public spaces spanning all seven continents, including cities such as New York, Paris, Melbourne, Seoul, Hong Kong, and London.
Stop XDR-TB logo posted by  ElseKramer on Flickr.