Drug-resistant strains of tuberculosis have appeared in many places throughout the world in the last 50 years, including the USA, Russia and Azerbaijan. In Russia in 1997, drug-resistant tubercular cases spread into the population at large, as some of Russia's 1 million prisoners were released from overcrowded jails, where disease spreads readily. While the official toll is 2481 cases per 100,000 prisoners, unofficially the incidence is 50%. The incidence of TB in the Russian non-prison population has tripled to 70 cases per 100,000. In Azerbaijan there are officially 4667 TB cases per 100,000 prisoners, of whom one quarter die. 56,000 prisoners were released in 1996, many of whom were known to be suffering from drug-resistant TB. In Russia and Azerbaijan the prevalence of TB is also rising to the levels of the 1970's. This, poverty due to economic upheaval, and a lack of medical services, have contributed to Russia's mortality rate, now the highest in Europe. In the USA there are 8.7 TB cases per 100,000 people.
Drug resistance is regarded as the key driver of the increased sales of antibiotics, following a slump in the 1980s. The worldwide market for antibiotics was worth $20 billion in 1991, 12% up on 1990. Estimates of the total cost of antibiotic resistance in the USA range up to $30 billion a year.
2. Within a few decades viruses, bacteria and fungi will have evolved complete resistance to the human pharmaceutical arsenal.