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Tuesday, July 29, 2014
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Published: Friday, 3/29/2013

Tackling TB

Federal budget cuts under the so-called sequester will reduce nondefense spending that is not required by law by 5 percent. Misguided across-the-board cuts that undermine efficient and inefficient programs alike apply to U.S. global health efforts, which are underfunded and represent only a sliver of the budget.

For this year, the proposed outlay for the Global Fund to Fight AIDS, TB, and Malaria amounts to $1.65 billion, but the sequester would reduce that amount by more than $75 million. Worse, the budget introduced by Rep. Paul Ryan (R., Wis.), chairman of the House Budget Committee, would cut U.S. spending on the Global Fund by another 7 percent.

Any cut to the Global Fund — the largest and arguably most effective supporter of programs to fight HIV, tuberculosis, and malaria — is unacceptable. Since it started in 2002, the fund has saved millions of lives in Africa, Asia, and Latin America. It has bolstered America’s stature in the developing world, and made the world safer and more stable.

Moreover, every dollar the United States contributes to the fund is matched with $2 from other donors. When our nation leads on global health initiatives, others follow.

With another worldwide health threat posed by strains of drug-resistant TB, U.S. support for the Global Fund should not only be maintained but increased. Usually treatable with inexpensive drugs, TB can, when it is treated improperly or inconsistently, develop resistance to these drugs. Treating the disease then costs up to 40 times as much — as much as $200,000 per person in the United States.

Health experts say that around the world, rates of drug-resistant TB are higher than expected. The World Health Organization projects more than 2 million new cases from 2011 to 2015, with only 10 percent of them properly treated.

Nor is the United States immune. In Los Angeles, public health officials are battling an outbreak of TB among homeless people. Health departments nationwide face TB drug shortages.

Drug-resistant TB cases appear to be rising. A significant increase in such cases could overwhelm the U.S. public health system, advocates say.

The Global Fund provides most — about 90 percent — of international aid for controlling TB. More than $1.5 billion in added funding is needed for early and effective treatment.

In 2011, 1.4 million people died because of TB; the greatest per-capita death rate is in Africa. TB remains the world’s most deadly curable infectious disease.

Overall deaths caused by TB are falling. Yet a growing number of drug-resistant cases poses a global threat, as some 630,000 people carry such strains.

In 1882, Dr. Robert Koch, a German scientist, discovered the mycobacterium that causes tuberculosis. Today, the fight against TB requires a renewed commitment to the Global Fund.



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