Commentaries

In Africa, Moving From A Brain Drain To A Brain Gain

Dr. Menghis Bairu

Africa’s ability to reach its economic potential has been stymied by a brain drain, the loss of well-educated professionals who seek opportunities in developed countries. A 2013 report from the United Nations and the Organization for Economic Co-operation and Developmentfound one in nine Africans with a tertiary education—some 2.9 million people from the continent—were living and working in developed nations in North America, Europe and elsewhere. Read more…

On World Tuberculosis Day, Africa Needs to Grow Impatient

Dr. Menghis Bairu

Growing up in Africa, I remember my grandmother constantly coughing. She was quarantined many times because of tuberculosis, but she never seemed to recover. Now, despite the advances of medical science, little has changed for patients like her.

TB is the world’s second deadliest infectious disease. It kills 1.5 million people each year and is the only major drug resistant infection that is airborne. As World Tuberculosis Day calls attention to the disease March 24, we are confronted with the harsh realities from the toll from TB. If we fail to solve the challenge of drug resistance, over the next 35 years 75 million people will die from multi-drug resistant TB and the disease could cost the global economy $16.7 trillion, according to a new report from the UK All Party Parliamentary Group on Global TB.

“These figures show us in no uncertain terms that the rising global burden of MDR-TB and other drug-resistant infections will come at a human and economic cost which the global community simply cannot afford to ignore,” says Jim O’Neill, chairman of the independent review on Anti-Microbial Resistance, which developed the economic projections used in the report.

We can find novel therapies for so many diseases—even rare ones— but we seem to be unable to do so for tuberculosis. People in emerging markets wait at their peril for pharmaceutical companies in the developed world to put their full muscle behind an effort to address the threats posed by MDR-TB.

Since 1967, no new drugs have entered the standard TB treatment regimen, and only two new anti-TB drugs have been developed and approved by the European Medicines Agency since it was created in 1995, the UK All Party Parliamentary Group on Global TB report found.


There are companies that have invested great amounts of time, resources, and money into research and development to advance promising drugs and win regulatory approval.  My hope now is that they will expeditiously and successfully launch their products, make them affordable, and take the necessary steps to ensure they reach the unfortunate millions of MDR-XDR TB patients. 


Treatment for drug-resistant TB can take up to two years, and is so complex, expensive, and toxic that less than half of people successfully complete treatment. And we continue to fail in our efforts to rein in the disease. The World Health Organization’s strategy projects the elimination of TB as a public health threat over the next 20 years, but the report notes that The WHO’s projections assume rapid reductions in the rates of the disease that are not being realized today.  In fact, the report notes that not only could we fail to meet the already ambitious targets for TB reduction, but that the number of lives claimed by the disease could actually increase as a result of drug-resistance.

The threat of TB is of particular concern to African nations. In 2012, Africa experienced 8.6 million new cases and 1.3 million TB deaths. In fact, nine African countries are among the 22 nations with the highest TB burden in the world including South Africa, Nigeria, Democratic Republic of Congo, Ethiopia, Kenya, Tanzania, Uganda, Mozambique, and Zimbabwe.

The problem is not just a lack of drugs, but diagnostics too. Despite the large number of cases four in 10 TB cases remain undetected.

The solution for Africa involves a strategy that includes the use of technology to drive education and compliance, the use of point-of-care diagnostic and monitoring tools, and creative stakeholder engagement. But it also requires us to lead, rather than follow, if we are to address our health needs. We must take the scientific lead in collaboration with global players to find local solutions.