March 21, 2013
The lives of 20 million people have been saved in recent years because the United States and other governments have scaled up their campaign against tuberculosis (TB), working to overcome one of the world’s most deadly diseases, the U.S. Agency for International Development (USAID) says.
A bacterial disease, TB is spread easily through the air, causing more than 8.5 million infections in 2011, the World Health Organization (WHO) reports, using the most recently available data. TB took more than 1.4 million lives that year. It is a particular threat to people living with HIV/AIDS, and a frequent cause of their deaths.
International commitment and effort to battle TB are highlighted on World TB Day, March 24, which commemorates the discovery of Mycobacterium tuberculosis by Robert Koch. The German physician and scientist won a Nobel Prize for that discovery in 1905.
The President’s Emergency Plan AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, TB and Malaria and partner governments have intensified efforts in recent years to reduce the burden of this disease. PEPFAR ranks accurate diagnosis and treatment of TB as the first step in achieving its Blueprint for an AIDS-Free Generation.
“[The U.S.] Congress has recognized TB as an important humanitarian issue and increasingly as a potential threat to global security,” according to a 2012 report on the U.S. response issued by the Congressional Research Service (CRS).
Annual U.S. support to international TB programs was about $90 million through several years of the last decade. Congress pumped up the U.S. allocation for the disease, CRS found, in response to evidence of TB’s capability to move rapidly across international borders. Annual U.S. funding surged to more than $160 million in 2008, and has remained near that level for the last several years.
More than 50 million people have been successfully diagnosed, treated and cared for as a result of recent intensified efforts, according to WHO. Working with governments around the world, USAID and other international organizations pursue an ongoing campaign to scale up prevention, diagnosis and treatment. Their goal is to cut TB deaths and disease occurrence in half by 2015.
Technology is boosting the effort. International adoption of a new diagnostic method allows a person to learn his or her TB status on a one-visit, while-you-wait basis. USAID and partners are also working to put community-based TB care in place, making treatment more accessible to patients and reducing the burden of TB on families.
Another key benefit to that strategy is that early and accessible treatment will reduce the chance that one patient will pass the disease to others. Convenience of treatment will also reduce the development of multidrug-resistant TB (MDR-TB). This tougher strain of the bacterium has complicated the campaign against the disease over the last decade.
TB treatment is long, requiring strict adherence to a drug regimen. Often, patients find it difficult to follow the treatment’s full course. They think they are better before they really are and they stop treatment. That’s when MDR-TB develops and becomes a disease requiring specialized and more expensive drug treatment.
The United States supports programs to develop greater skills and awareness among health providers, communities and patients to better understand the special treatment and care needed to address MDR-TB. Research and technology may also provide better responses to MDR-TB. Development of a shorter treatment regimen, more efficient diagnostics and an effective vaccine may all be on the horizon in the next decade, according to USAID.
An international coalition, the Stop TB Partnership, finds that the surge of MDR-TB is due in part to “underinvestment and insufficient action” against the disease burden. Drug-resistance cases are especially prevalent in Eastern Europe and Central Asia, with MDR-TB exceeding one-third of all cases, the partnership says.
“Unless we get MDR-TB under control,” the partnership warns in a a World TB Day message, “the cost of dealing with it later will bankrupt many health budgets.”
Leaders of the WHO and the Global Fund recognized TB Day with an appeal for greater funding for TB treatment from both international donors and 118 low- and medium-income nations where the disease is widely circulating.