The tuberculosis bacterium kills an estimated 1.5 million people globally every year. If left untreated, it can cause death within 18 months. The World Health Organization (WHO) recommends a treatment regimen known as directly observed therapy, short-course (DOTS), which consists of four antibiotics taken under medical supervision for six months.
Stuckler says the disease is considered an overall indicator of a population's health, "If you see tuberculosis rates rise, you expect bad things to come," he says. "Mortality is an immediate response to inadequate access to care." Improper treatment is also believed to be the primary reason why strains of the bacterium have emerged that are highly resistant to antibiotics.
The problem is not limited to a single country, as was demonstrated last year by the case of Andrew Speaker, an Atlanta lawyer diagnosed with extremely drug-resistant TB who boarded an international flight from Rome to Montreal and drove across the U.S. border despite warnings by U.S. health officials.
Stuckler says it is worth thinking about the best way for the IMF to proceed. "It's not the case that medical mismanagement in Russia only matters there," he says. "Tuberculosis has wings."