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Pulitzer Center Update June 16, 2015

This Week: Lowering the Cost of TB Testing


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Image by David Rochkind. Vietnam, 2014.

Vietnam has less than 30 percent of the funding needed to fight tuberculosis. With only the most...

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Patients wait for a consultation at the Phom Ngac Thach hospital. Image by David Rochkind. Vietnam, 2014.


Although tuberculosis stubbornly remains the second deadliest infectious disease on the planet, there was a feeling in the health care industry that curing it simply wasn't profitable enough. "The word on the street was that TB was a disease of the poor and there wasn't enough money in it," one expert told Pulitzer Center grantee Jens Erik Gould. But as Jens reports in this piece for The New York Times Fixes blog, things began to change in 2010 when the California-based diagnostics company Cepheid Inc unveiled GeneXpert, which uses automated molecular technology to quickly detect the presence of TB—the first real breakthrough in early detection of TB in nearly a century.

"The problem is that not everyone has access to it. Not long after the rollout, health care workers began realizing that GeneXpert wasn't designed for the people who needed it most: the poor in the developing world. Even though donors were mostly paying for the $17,000 machines, the $10 cartridges were too pricey for many countries to afford on a mass scale. The setup also required electricity, computer access and refrigeration—not easy to come by in rural areas where TB is prevalent."

But ironically, those shortcomings have spurred new interest in tuberculosis care. "The overwhelming excitement about GeneXpert among health officials and the substantial investments made by donors quelled doubts that there was demand for new TB technology and that it could be profitable," writes Jens. "As a result, more companies have entered the TB market and are competing to develop diagnostic technologies that would provide the benefits of GeneXpert, without the drawbacks. The lesson? Often, it's the drawbacks, even more than the benefits, which can spur a paradigm shift."


The plight of Iraq's ethnic Yazidi community after the rise of the Islamic State last summer is a litany of misery: forced conversions, executions and the sexual enslavement of women and children. Pulitzer Center grantee Emily Feldman has been following the crisis from the beginning.

Although the Yazidis were singled out for special torment, Emily reports that no one seems spared from the chaos. "Muslims, Christians and minorities in the jihadists's path have either been slaughtered or forced from their homes. Villages, towns and cities across the country are now deserted," she writes in a recent series of dispatches for Mashable.

"Activists and NGOs, meanwhile, are scattered throughout the region, attempting to organize the madness of war in handwritten lists and excel spreadsheets. They are checking in on people, going door-to-door," says Emily, who also spoke to the BBC about what she witnessed. "Thousands, though, are still missing. And though exact numbers are hard to come by in this war-torn region, activists believe as many as 3,000 Yazidis may still be held in ISIS slavery."


The Kingdom of Saudi Arabia stakes its legitimacy on the austerity with which it enforces Sharia law. The militant Islamic State (IS) follows the same logic. It may seem strange that the two have become mortal enemies, but as Pulitzer Center grantee Elizabeth Dickinson explains, the competition between the Saudis and IS is one reason their conflict stands to be so fierce.

"Over the last eight months, Saudi Arabia has arrested 1,059 men with alleged ties to terrorist groups, including local cells of the so-called Islamic State (IS). The sweep followed a string of attacks attributed to IS, the most deadly of which have targeted Saudi Arabia's Shia communities," she writes in her two-part series for GlobalPost.

"For now, authorities say IS and its imitators are more nuisance than significant threat to the country's security. But with each attack, it becomes more difficult to write off the violence as isolated." The biggest headache for the Saudis, says Elizabeth, is keeping their own citizens from joining IS. "Nearly all of the suspects named in the recent assaults have been Saudi citizens or residents."

Until next week,

Tom Hundley
Senior Editor


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