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  1. Andrew Bush,
  2. Ian Pavord, Editors

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A Chinese cracker

Following on from Zarir Udwadia's Hot off the Breath article on totally drug resistant TB (Thorax 2012;67:286–8), China is now coughing and the world should be listening. Liang et al (see page 632) report on the factors leading to the staggeringly high prevalence of multi-drug resistant TB (12% of 1995 patients tested). Depressingly, the causes are largely preventable; among these were the need for re-treatment, delay in initiating treatment, financial burdens, poor knowledge of the disease, poor coordination of services and supervision of treatment and neglect of infection control. No reason at all to believe this is just a Chinese problem, which is why we published the manuscript. So what are the lessons that we show no sign of learning? First, treatment of newly presenting TB is an urgent matter to get right; cancer surgeons would not randomly hack out a bit of lung somewhere near a tumour and hope for the best. They go for the definitive surgery, and so should we with TB treatment. Second, yet again, KISS …

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