This past January, Dr. Charity Thoman started noticing the shortages. Santa Barbara County’s normally stocked tuberculosis drugs were disappearing off the shelves, and instead of more drugs arriving to replace them, they stopped coming altogether.
“That’s unprecedented,” said Thoman, who has been watching those critical drugs become harder and harder to come by for the Santa Barbara County Public Health Department and health-care providers across the nation since the beginning of the year. “A hundred years ago, tuberculosis was the No. 1 killer in the United States.”
Because public health attacked the problem aggressively in the following decades, “these days no one’s even heard of it,” she said.
But Thoman said California continues to have a persistent problem with tuberculosis.
In fact, 2.3 million people are infected with latent tuberculosis, which Thoman likened to the disease being “asleep in your lungs.” In Santa Barbara County, about 25 cases of active tuberculosis surface a year.
With each case, county health officials have to conduct an expansive investigation of each family member, co-worker and friend with whom the infected person may have come into contact.
“We find positives all the time,” she told Noozhawk. “That’s what so dangerous.”
The drug Isoniazid is one of four medications used to treat tuberculosis when it’s first seen in a patient, when the disease becomes “active.”
Isoniazid is the most important of those drugs — so much so that Thoman called it “the backbone” of treatment throughout the world.
Because tuberculosis is spread through the air and highly contagious, it’s a public health issue when those drugs aren’t available, Thoman said. Isoniazid is the medicine used to treat latent tuberculosis as well, and without the drug, more and more people will develop the full manifestation of the disease.
“The problem with this drug shortage is that we won’t see effects right away,” she said. “We’ll probably start seeing a big increase in five or 10 years.”
Thoman said because the drug is generic, “it doesn’t make the drug companies any money.”
Of the three companies that make the drug, one has stopped taking orders altogether.
Thoman said that instead waiting for drug companies to fix their own problems, more intervention is needed — even a presidential order.
“It’s really going to take change at the federal level,” she said. “President Obama issued an executive order to try to address drug shortages, but the order wasn’t aggressive enough, so it hasn’t really produced results.”
Click here to find out more about tuberculosis in California and how health departments are treating the disease.