Tuberculosis: a long fight against it and its current resurgence.

Abstract

Unlike the discovery of penicillin in 1928 by A. Fleming, largely due to fortuitous circumstances, the isolation of streptomycin by S.A. Waksman was the result of a systematic research project carried out by a number of workers. In 1952, Waksman received the Nobel Prize in Medicine for having produced the first useful drug against tuberculosis. Before the tubercle bacillus was recognised as the causative agent of the disease, various sanatoria had been set up, as the only remedy for sufferers of tuberculosis. Between 1880 and 1930 sanatoria spread across Europe and North America, and they were partially effective against the ever worsening diffusion of tuberculosis: therefore in the United Kingdom a government-funded agency, the Medical Research Council (MRC), was created in 1913. In 1947 streptomycin was put on the market, opening a new era in the history of modern medicine. Indeed, the first published report of the results of an (individually) randomised clinical trial was the 1948 paper by Bradford Hill and co-workers of the MRC's trial on the use of streptomycin. Streptomycin still represents a first-line agent in the recommended therapy of tuberculosis, whose burden is far higher in low-income countries. The current aim of any global intervention against tuberculosis should be the elimination of the pathology itself, an effort that will need both financial investments in scientific research and the targeted use of the fruits of that research to develop new, effective, preventive and therapeutic tools, such a tool as streptomycin proved to be more than fifty years ago.