( CNN ) -- `` Sometimes I ask myself , why me ? Why did this have to happen again ? '' says 31-year-old Andile from the Khayelitsha township in Cape Town , South Africa . `` But the problem is I could have got it anywhere , on the bus , in a taxi , in my work . It 's everywhere . '' Andile has extensively drug-resistant tuberculosis ( XDR-TB ) , a form of the airborne disease that is resistant to the four main groups of drugs used to treat it , meaning treatment can take years and requires alternative drugs that have more side effects . He 's had tuberculosis for more than two years but it 's not the first time he 's been infected . `` Where I stay , the environment is not right , it 's not clean . I could have got TB there , or on the taxis we use as they never open the windows , '' he says . TB has long been known as a disease of poverty . Dense housing , shared living space , poor ventilation , poor nutrition and poor healthcare systems are the prime conditions for the infection to spread , and thrive . This ancient disease was known as the `` White Plague '' in 18th century Europe and still kills more than one million people a year globally . It 's a complicated disease with the potential to affect many parts of the body and it can remain latent in people for many years , leaving them unaware they are infected . The main active form of the disease affects the lungs ; if left untreated it can cause considerable lung damage , resulting in eventual death . 'Public health emergency ' After repeated exposure , Andile has extensive damage to his lungs , leaving him reliant on an oxygen tank as he receives his treatment from Medecin Sans Frontiers . The NGO plays a large role in treating TB in Khayelitsha , one of the largest townships in the country . Andile is one of thousands of people who contract the extensively drug-resistant form each year and he makes a crucial point -- TB is everywhere in South Africa and is the leading cause of death . It 's estimated that up to 80 % of drug-resistant forms of the disease are now transmitted directly between people , rather than developing over time . `` The disease has reached a public health emergency in South Africa , '' explains Keertan Dheda , professor of medicine at the University of Cape Town . `` We treat half a million cases a year and today , the epidemic has taken a turn with drug resistance . We treat 8,000 cases of resistance a year and now a chunk of those have developed resistance beyond XDR-TB -- incurable TB . '' Looking at the disease globally , in 2013 there were 72 cases of drug-resistant TB in the United States . In 2012 there were 64,000 cases in India and 59,000 in China . The more people and the closer their proximity , the easier the disease spreads . Drug resistance can develop for a variety of reasons . For TB , the origins lie in incomplete treatment regimens where people did not complete their course of antibiotics due either to poor health systems or personal preference or complacency . Incomplete treatments mean the bacteria behind the disease -- Mycobacterium tuberculosis -- have had some , but not full , exposure to the drugs prescribed to kill them , giving them the opportunity to mutate and become resistant . The result today is such vast resistance that in some settings , all known drugs have been rendered useless and these forms are now transmitting between people . `` We now have patients who are therapeutically destitute , '' explains Dheda . Global problem . The problem is now global . XDR-TB has its highest prevalence in Russian , Eastern Europe , China and India , with the latter reporting cases of total drug resistance . But according to the 2013 Global TB report from the World Health Organization ( WHO ) , this extensive form of resistant TB has been reported in 92 countries , and is likely to be in more . `` It 's probably in every country , '' says David Heymann , head of the Center on Global Health Security at think tank Chatham House and chair of the Health Protection Agency in the United Kingdom . `` The disease has spread internationally and is a real concern . '' The 67th World Health Assembly took place last week and it approved a long-term global TB strategy , including targets to reduce TB deaths by 95 % between 2015 and 2035 . Also firmly on the agenda was the global concern of antibiotic resistance and the fear of many diseases becoming untreatable . The issue has been addressed by many public health organizations in 2014 and Heymann believes TB is a prime example of the problem and should be declared a public health emergency of international concern by the International Health Regulations Emergency Committee . But such a declaration is yet to be made . The man in charge of the controlling the problem globally is Mario Raviglione , director of the Global Tuberculosis Program at the WHO . `` TB is competing with HIV/AIDS as the number one killer among the infectious diseases , '' explains Raviglione . `` There are about 450,000 new drug-resistant TB cases every year and this is the scariest part of tuberculosis as you are left with less options to treat people , many of which are toxic . '' 'Extraordinary measures ' Raviglione stresses that the epidemic may differ in different parts of the world but is very much an international issue . `` Russia , India , China and South Africa have about 60 % of the world cases , so if they do n't improve there is no way the world can progress , '' he says . Raviglione is especially concerned about the increased rates of drug-resistant TB seen in Southern Africa . `` This scares us most because in that part of the world there is a lot of HIV and so it can become explosive and really spread and move fast as HIV amplifies the effect of tuberculosis . '' The ability of HIV to suppress human immune systems enables TB bacteria to take over the body . The WHO strategy therefore is to target high-burden countries and improve the diagnosis and treatment of drug-resistant TB . Because patients must take drugs for at least two years , getting them to stick with the treatment is essential , and transmission must also be controlled . Not a simple feat . `` This threat has to be prevented and when it does occur , extraordinary measures must be put in place to diagnose and treat to stop it spreading to others , '' states Raviglione . `` It 's a real threat and has to be taken extremely seriously . '' This story was partly supported by the Pulitzer Center on crisis reporting .
Drug - resistant tuberculosis is on the rise , with some strains immune to all major drugs . Extensively resistant TB reported in many countries but is likely to be in many more . About 450,000 new drug - resistant TB cases reported worldwide in 2008 . ` ` It 's probably in every country , '' one expert .