Last week, the World Health Organization (WHO) released their most comprehensive report to date on multidrug-resistant and extensively drug-resistant tuberculosis (MDR/XDR-TB). WHO's top TB official said the new data demonstrate a "serious threat to global health, with rich and poor countries, all countries, at risk." The New York Times reported that strains of MDR-TB were "spreading at deadly rates."
Against this alarming backdrop, the Obama Administration is surprisingly cutting funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria -- the single largest external contributor to global efforts to fight tuberculosis (TB) and MDR-TB.
Here is a little bit of background. The drugs to treat regular TB can cost as little as $20; drugs to treat MDR-TB can cost hundreds of times more and be far more toxic. Worse, strains of TB have now developed that are resistant even to the drugs used to treat MDR-TB. Known as extensively drug-resistant tuberculosis (XDR-TB), these strains are even more costly and difficult to treat and too often are a death sentence. Since XDR-TB was first identified in 2002, cases are now being reported in 58 countries. And while the numbers found within the WHO's report are shocking, even more worrisome is the fact that no reliable data exist for 79 countries. In essence, we don't know the full extent of the situation.
However, there is hope in all of this. As difficult and costly as MDR-TB can be to treat, we know how to do it and are having great success in countries that are addressing the situation seriously. Latvia and Estonia, which once had skyrocketing rates of MDR-TB, have been able to reverse these trends with proper testing and treatment. And programs in some of the most resource poor settings are showing success. And with investments in stronger basic TB programs, we can prevent MDR-TB from occurring.
Unfortunately, the rise of MDR-TB -- and the emergence of XDR-TB -- is a global health crisis of our own making. We developed the antibiotics to treat and cure TB more than half a century ago, yet more than 9 million people in the world become sick with TB each year, and 1.8 million of them die from this curable scourge. Because of inadequate or incomplete treatment in many parts of the world, TB has adapted itself to be impervious to the drugs that once used to cure it. TB is airborne -- the risk factor, breathing. All you have to do is share the same air. In our interconnected world, the impact of this public health failure will not be isolated. The Department of Homeland Security has labeled XDR-TB an "emerging threat to the homeland."
In response to this alarming news, one might assume that the U.S. and other wealthy nations would increase funding to prevent MDR-TB by strengthening quality routine TB treatment -- ensuring everyone gets the right treatment and gets cured -- and, seriously scaling up treatment of MDR-TB before it spirals out of control, which may not take long given that only 7 percent of all MDR-TB patients are being diagnosed. Increased investment in new and better diagnostics, drugs and an effective vaccine is also crucial.
But this is not what is happening. In fact, faced with this global epidemic and security threat, the United States is doing the opposite.
The Bush Administration made historic progress against AIDS, TB, and malaria and as President Bush's years in office came to end, there was hope that the next administration would take the global fight to the next level. Presidential candidate Barack Obama promised to increase support for the Global Fund. In 2008, a strong bipartisan majority, which included Senators Obama and Biden, passed the Lantos-Hyde U.S. Global Leadership Against HIV/AIDS, TB and Malaria Act, which authorized a $4 billion five-year plan to fight TB.
Sadly, in a major broken promise, President Obama's budget blueprint actually slashes $50 million from the U.S. contribution to the Global Fund, which provides two-thirds of donor funding for TB programs in poor countries. And while Senators Obama, Biden, and Clinton all voted for the Lantos-Hyde plan to ramp up the fight against TB, now, they have not prioritized investment commensurate with the scale of devastation of this disease.
In response to failure, eight major U.S. banks received $175 billion in taxpayer funds -- and did not bat an eye at using that taxpayer money to pay out $32.6 billion worth of bonuses in 2008. Since then, the Global Fund has saved an average of 3,600 lives per day through financing effective, results-oriented health programs in over 140 countries. Surely these life saving measures deserve a fraction of the amount paid to the failed banks. Now more than ever, it's imperative that President Obama and Congress fully fund the Global Fund at $1.75 billion in 2011 and increase funding for TB as authorized by Congress in the Lantos Hyde Act.
Joanne Carter is executive director of RESULTS/RESULTS Educational Fund and a member of the board for the Global Fund to Fight AIDS, Tuberculosis and Malaria.
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