An Iron Fist Joins the Malaria Wars - New York Times

An Iron Fist Joins the Malaria Wars - New York Times: "he tuberculosis world, Dr. Kochi said, used to be just as fragmented and hostile as the malaria field is now. Then, in the early 1990's, an explosion of multidrug-resistant cases everywhere from New York City to Peru to Siberia forced the advent of a new paradigm: four-drug cocktails, taken daily for six months, always under the eye of a nurse or someone else appointed to oversee treatment, even an imam or a faith-healer.

Under Dr. Kochi's leadership, countries were urged to diagnose and treat in standard ways (sputum smears instead of chest X-rays, for example, or four cheap antibiotics instead of exotic drugs and pulmonary surgery). Drug companies were asked to standardize products so each patient could be handed a box with six months' worth of pills. As a result, some partners, like tuberculosis hospitals and makers of the old BCG vaccine, were very unhappy.

Malaria, he said, will need a similar shift, because everything is wrong with the efforts to fight it: lax counting of cases, mixed messages on which medicines to use, counterfeit drugs, expensive consultants, slothful national governments, weak international leadership."