Global health got an important shout-out from US President Barack Obama during his State of the Union speech last night. In fact, his revelation that he will call for Congress to fund malaria was one of the few tangible pledges made to mark the last year he will be in office.
"When we help African countries feed their people and care for the sick, that prevents the next pandemic from reaching our shores," said Obama. "Right now, we are on track to end the scourge of HIV/AIDS, and we have the capacity to accomplish the same thing with malaria — something I’ll be pushing this Congress to fund this year."
Missing from the address was Tubercluosis, and it is no small omission. HIV/AIDS and malaria are terrible, but did you know that TB actually kills more people each year? That's right. TB is responsible for 1.5 million deaths globally, HIV/AIDS is responsible for 1.2 million deaths, and malaria is under 1 million.
No longer is TB the disease that kills the hero in western movies, it is a global problem that spreads easily between people and is increasingly resistant to available treatments. Despite that fact, it is less funded and even discussed than malaria and HIV/AIDS.
What makes the lack of mention surprising is the fact that the White House announced a National Action Plan to Combat Multidrug-Resistant TB (MDR-TB) just a few weeks ago. It outlines a plan that will support the domestic response to MDR-TB, leverage partnerships at the international level, and put more support to research and development of tools to fight MDR-TB. Advocates welcomed the plan, but pointed out that money needs to be behind it to make sure the goals set are achieved.
“The Administration should seize the opportunity of this new plan by committing the funding needed to operationalize it,” said said Dr. Joanne Carter, Executive Director of RESULTS. “As negotiations are underway for the FY 2017 budget, this plan must pave the way for an ambitious funding request.”
It is hard to imagine such a request happening. The Obama administration has proposed cuts to global TB funding the past four years. It is Congress, in fact, who has turned away and helped to maintain funding. The ominbus spending bill approved by Congress this month held funding at $236 million USD for Fiscal Year 2016.
What makes TB parcularly important to the US is the fact that it is a threat to all Americans. The anual number of infections in the US is just below 10,000. Treatment costs anywhere from $17,000 to $482,000 per patient, depending on how resistant the TB is to drugs. Recently, an outbreak in Alabama infected more than 20 people, killing 3.
But the real concern is the fact that few new drugs are in the pipeline even when more than 10,000 peple are diagnosed with MDR-TB (i.e. drug resistent TB) each year. That number can, and will, go up if better testing and treatment is not available. The world's deadliest infectious disease is a threat to people everywhere in the world, yet it does not garner a mention in Obama's major speech.
Go figure.