Christoph Lange is Professor of Medicine at the University of Lübeck and Head of the Clinical Tuberculosis Center of the German Center for Infection Research (DZIF) at the Research Center Borstel (Germany). He is currently the Head of the Respiratory Infections Assembly for the European Respiratory Society and was the founding chairman of TBNET.
Can you tell us about your area of work?
As a clinician scientist, I work in the fascinating field of respiratory medicine at the Medical Clinic of the Research Center Borstel in Germany. My interest area is in mycobacterial respiratory infections, especially tuberculosis. Borstel is the location of the National Reference Center for Mycobacteria and the Clinical Tuberculosis Center of the German Center for Infection Research. Tuberculosis is very often related to poverty and many of our patients have travelled far and have taken high risks in search of a better life. I have great respect for their courage. However, the situation will not improve if we do not support the poorer countries, their economies and healthcare systems. This is an enormous challenge to which we are committed.
How did you become involved in this field of work?
As a medical student I had the opportunity to visit the University of Cape Town in South Africa at the beginning of the AIDS epidemic and this changed my career plans from neurology to infectious diseases. Later I was enrolled in a fellowship in clinical infectious diseases at the University of Cleveland in the US, one of the top places for tuberculosis research at that time. I had the fortune to have a wonderful mentor who introduced me to the world of science.
What is the main aim of World TB Day?
On March 24rd 1882 Robert Koch presented in a lecture to the Physiology Society in Berlin that he discovered that the aetiology of tuberculosis is a bacterium. At that time tuberculosis was responsible for every second death in the age group between 15 and 40 years in Germany. In the year 2012 still more than 1.4 million people died from tuberculosis world-wide. Every year on March 24th, those who are engaged together in the fight against tuberculosis raise awareness about tuberculosis and highlight that it is a preventable and curable disease.
What are your key challenges at the moment?
The emergence of drug-resistance in strains of Mycobacterium tuberculosis has taken place in the absence of new drugs for the treatment of patients with multidrug-resistant TB (MDR-TB) or extensively-drug-resistant TB (XDR-TB). Despite a recommended treatments, cure rates in MDR-TB and XDR-TB range from 40- 65% on average. In some countries in Eastern Europe more than one third of all cases of tuberculosis are caused by an MDR-TB or XDR-TB strain of M. tuberculosis. Improving tuberculosis prevention, development of a simple point-of care test, individualizing the treatment, improving the clinical outcome and raising the quality of life especially for patients with MDR-TB and XDR-TB are the key challenges in our field at the moment.
What changes do you hope to see in the future regarding the treatment of MDR-TB and XDR-TB?
For many patients the intensity and the duration of the therapy in MDR-TB and XDR-TB are hard to tolerate. It is not unusual that patients have to interrupt their treatment due to side-effects of the treatment. Patients would benefit from different drugs that cause less harmful side-effects, substantially shorter treatment times and individualised anti-tuberculosis therapies. However, at present probably more than 80% of patients with MDR-TB and XDR-TB have no access to appropriate diagnostics and treatment. Improving access to existing diagnostics and therapies will have an enormous impact.
What do you enjoy most about your work?
I am grateful to be part of an enthusiastic local and international research group and I enjoy the interactions with my teachers, colleagues and students. I really enjoy meeting patients and bedside teaching with the medical students and residents. Recently I was appointed to the faculties of Medicine at our partner Universities, the University of Medicine and Pharmacology in Chisinau, Moldova, and the University of Namibia, in Windhoek, Namibia. Going to both places regularly for teaching makes me feel I am in the right places at the right time.
What are you most proud of in your career?
In the year 2006 I was privileged to be part of the founders of the TBNET, a “grass-roots” research network for tuberculosis in Europe. Today, TBNET has more than 600 members in more than 40 countries. It is a wonderful opportunity to share research ideas and to plan and conduct clinical research in Europe. TBNET is also seeking consensus on clinical management issues where scientific evidence is still lacking. In education the TBNET Academy provides a forum for young clinicians and scientists from all parts of Europe to build junior networks. TBNET has made a difference to the situation of tuberculosis in Europe and I am grateful to be part of this team.
Is there anything else you’d like to share with our readers?
Building a professional network with colleagues across borders in Europe has broadened my horizon and created returns of investments on different levels, not the least the friendships and partnerships that have been formed. But also towards more awareness of the problems of our neighbours, which are also our problems. It is my hope that many colleagues will also be able to share the opportunity to experience Europe in this way.
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