On March 24, 1882, German microbiologist Robert Koch identified the cause of tuberculosis, Koch’s bacillus. A century later, the World Health Organization designated March 24 as World Tuberculosis Day to raise awareness and spur action.
Tuberculosis has haunted humanity for thousands of years, but real progress toward elimination began in the mid-20th century. Today, there are several TB drugs in use, and their combinations can clear the infection. The initial intensive treatment phase typically lasts from two to six months, followed by a continuation phase that may extend up to a year. In the most severe cases, TB therapy can span several years. Yet drug therapy is not always enough, and some situations require more aggressive approaches.
As one expert notes, not all antibacterial drugs work against tuberculosis. The causative Mycobacterium tuberculosis and the disease’s progression limit the options. A small set of drugs shows activity against TB, while many antibiotics are ineffective. Treatment is long and complex, usually involving four drugs at the start, and five to six drugs if drug resistance emerges. If a patient does not adhere to the prescribed duration and dosage, resistance can develop, making the disease harder to treat. Sticking to the regimen remains the key to recovery.
Surgical intervention comes into play when conservative treatment fails or when the disease has progressed to cause irreversible tissue damage or dangerous complications. About 10–15% of patients with tuberculosis may require surgery. Surgical strategies in pulmonary TB rely on the full range of modern thoracic techniques. The choice of approach depends on many factors, including disease form. In localized lung TB, resections are typically smaller than those used in cancer surgery. Lymph node removal is targeted to affected nodes rather than all regional nodes. Some procedures once common in TB care—such as collapse therapy or cavity-focused operations—are becoming less frequent in major centers while remaining part of the repertoire in some regions.
Tuberculosis does not only affect the lungs. It can involve the genitourinary system, the abdomen, bones, and joints. In recent years, Moscow’s TB services have managed to reduce incidence and improve early detection through drug therapy and vaccination. The field has also explored novel techniques, such as valvular bronchoblockade, a method developed to limit ventilation to affected lung areas using a rubber valve. While promising in select cases, this approach carries higher risk and remains uncommon. It is not a stand-alone replacement for conventional medical or surgical treatment but can complement other measures when cavities are thick-walled and resistant to drug reduction. Clinical experience shows variable success with this technique, and it is best considered within a comprehensive treatment plan.
Experts emphasize that TB can affect anyone, yet it more often impacts the poor, the homeless, prisoners, and people with compromised immune systems. Pulmonary tuberculosis remains the most common form, though Koch’s bacillus can invade other organs. Transmission occurs through airborne droplets, and the disease may be asymptomatic for long periods. When symptoms appear, they can be subtle at first—malaise, pallor, mild fever, night sweats, and weight loss. In advanced pulmonary TB, a persistent cough with sputum, and sometimes blood, may develop over time.
In the former Soviet Union, vaccination and early detection helped reduce TB mortality. Yet the pace of decline slowed during the 1970s and 1980s, mirroring global trends. The 1990s brought a sharp rise in cases and deaths, linked to broader social and economic challenges. By 2000, incidence numbers showed a concerning level, but subsequent improvements in living standards and drug funding helped lower cases again. By 2019, Russia remained among the nations with a relatively high burden, though conditions varied by region. In 2020, some remote areas reported more than 100 cases per 100,000 people, while others reported as few as 4.6 per 100,000. The exact numbers reflect ongoing public health efforts and demographic differences across the country.
According to public health authorities, Russia recorded 44,974 new TB cases in 2021, with an incidence rate of 30.71 per 100,000 people. This marked a reduction from 2010, reflecting progress in prevention and treatment efforts. The burden among children under 17 also declined, with 2,276 cases in 2021 and an incidence rate of 7.49 per 100,000 children. These trends highlight the impact of vaccination, early detection, and sustained drug therapy on shifting the trajectory of the disease.
Overall, TB remains a global public health concern, necessitating robust vaccination strategies, rapid diagnosis, effective drug regimens, and, when needed, surgical support. The coordinated effort of clinicians, researchers, and health systems continues to move toward lower transmission, better outcomes, and eventual control.