Summary

In April 1998, a special meeting of physicians working on TB is convened at the American Academy of Arts and Sciences, a meeting to present the early results from the MDR treatment project in Peru. They want to show that they have had a more than 85% cure rate for MDR-TB patients. Howard Hiatt moderates the meeting and declares it an astonishing result that the world must hear about.

One of the world's ranking TB experts who attends is Arata Kochi, the head of WHO's TB program. He actually comes to quell the bad publicity Farmer had been stirring up, because he had been laboring for years to sell DOTS to the world. However, he has also come to the conclusion that WHO needs to come up with a solution for drug-resistant TB: one of his staff has coined the phrase DOTS-plus for this new initiative. He knows that they have to respond to clinicians like Paul Farmer who are screaming at them for help. It's time to start a dialogue. As for Farmer and Jim, they love the phrase and are encouraged by Kochi's attitude: if you can't beat them, join them, and then control them!

Kochi has made a dramatic concession, but the discussion is just beginning for other doctors there. One of the first to express his concern is Alex Goldfarb, a microbiologist from Russia who states first off that Russia is a TB nightmare. He is most........

Notes

The meeting with physicians from around the world is an important step in drawing attention the TB problem everywhere, but......

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