March 24 is World TB Day.
Most Americans think of tuberculosis as an antiquated disease of the past or of some remote, undeveloped nation. This, unfortunately, is far from reality: One third of the world’s population is infected with the TB bacterium, which is spread by coughing, and yearly 1.4 million people die each year.
Just this year, Los Angeles asked for federal assistance in controlling an outbreak where 4,500 could be exposed.
TB generally affects the poor, and because of this, for generations little attention was paid to its eradication. Now it has gotten stronger, and drug-resistant strains have evolved that are outrageously expensive, if not impossible, to treat. A 1991 outbreak of drug-resistant TB in New York City cost taxpayers $1 billion to treat about 200 people. With international tourism and travel commonplace, Miami-Dade County is at risk for such an outbreak because it is a gateway into the United States.
The cost of a full six-month drug course to treat nonresistant TB in places where it is most endemic is low, currently about $20 to $40. But this long course is often complicated by unpleasant side effects and frequently is not completed, leading to drug resistance and increased spread. A faster, simpler cure for TB will save millions of lives and have tremendous global benefits by improving compliance, cure rates and greatly decreasing the cost of delivery.
There is hope. New technology recently developed by a U.S. firm can decrease the diagnosis time from several days or weeks to two hours, and some new drugs have been approved. Researchers are working on a vaccine.
Clearly, there must be a massive, concentrated global push to completely eradicate TB, in much the way that smallpox was wiped out. We need U.S. leadership from President Obama in funding for the Global Fund to Fight AIDS, TB and Malaria, which currently provides almost 90 percent of the global investment in TB control. The Global Fund is a best buy in global health, since every $1 the United States contributes is matched with $2 from other donors. If we don’t pay now to control and end TB, we will pay for it forever.
Barbara Mihm, RESULTS, Miami