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Hard Lessons to Learn

Arch Intern Med. 2000;160:581-582.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

TWO ARTICLES concerning drug resistance in patients from Mexico published in this issue of the ARCHIVES^1-2 highlight key challenges to a global strategy for tuberculosis control.

Mexico has clearly reduced the tuberculosis problem from historically higher levels,³ evidenced by the character of the current epidemiological picture of the disease as primarily affecting older men and high-risk groups.² Despite recommendations by international authorities, the policies implemented thus far appear limited and in need of revision if Mexico is to achieve success against tuberculosis. This is evidenced by the high proportion of the most highly infectious (smear-positive) patients who have already gone through the system without having been permanently cured, a relatively high level of resistance to the medications available for treatment, and the consequent negative impact on treatment results. Furthermore, the failure to implement a unified surveillance system for all tuberculosis cases in the country limits the ability of the government . . . [Full Text of this Article]

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