Budget cuts endanger the CDC’s Tuberculosis Research Program

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CocoJervisThe following is a guest post by Coco Jervis, senior U.S.and global policy associate Treatment Action Group , the science-based treatment advocacy organization.

According to the World Health Organization, an estimated 8.7 million people became sick with tuberculosis in 2011, and more than 1 million are expected to die of the disease this year alone. Among all infectious diseases, TB is the second leading cause of death worldwide, the third leading cause of death for women of reproductive age, and disproportionately affects people living with HIV/AIDS in Africa. More than one-third of the world’s population is latently infected with TB—the reservoir of future active TB cases is staggering. And no one is immune.

The growing global epidemic of TB—especially drug-resistant TB—poses a direct and immediate threat to the public health and national security of the United States. At this moment, the Centers for Disease Control and Prevention (CDC) is racing to contain a troubling and costly outbreak of TB in Los Angeles. As a single case of drug-resistant TB can cost hundreds of thousands of dollars to treat, it makes good bipartisan economic sense, especially in uncertain economic times, to invest in the CDC’s efforts to prevent and treat TB.

TBTCMAP1

Credit: Centers for Disease Control and Prevention
TBTC Study Sites and Partner Institutions 2010-2020

Yet sequestration-related cuts are threatening to do just the opposite by damaging the CDC’s Tuberculosis Trials Consortium, the leading TB clinical research collaborative in the world. People currently fighting TB are challenged by long treatment courses (6–24 months), inadequate diagnostic tests, and limited options for preventing disease. The TBTC conducts critical research that could spur the development of shorter, better-tolerated treatment strategies for curing and preventing the spread of TB.

TBTCMAP2

Credit: Centers for Disease Control and Prevention
TBTC Study Sites and Partner Institutions 2010-2020

In 2011, TBTC studies produced the first new regimen in decades for preventing TB infection from developing into active disease, reducing treatment from nine months of daily medication to just 12 once-weekly doses. This new regimen is the shortest and safest treatment for latent TB infection to date, and has the potential to significantly improve treatment success rates of latent TB, thereby reducing the incidence of active TB.

Recently, a separate TBTC trial produced exciting results that could lead to shortening active, drug-sensitive TB treatment from six months to just three or four months. A shorter, safer, better-tolerated regimen would be transformative. Shaving even two months off TB’s long treatment course would mean one-third fewer patients on treatment at any given time, saving millions in treatment costs each year in the United States alone. But sequestration’s cuts may stop the TBTC from launching a late-stage clinical trial for this promising new treatment regimen.

TBTCMAP3

Credit: Centers for Disease Control and Prevention
TBTC Study Sites and Partner Institutions 2010-2020

Several TBTC sites have already been cut—and more may follow—hampering the TBTC’s ability to enroll patients into trials, narrowing the scope of research, and resulting in a loss of expertise. “Despite providing great value, the TBTC is already operating on a shoestring,”  Erica Lessem, assistant director of the TB/HIV project at Treatment Action Group, said.” If these devastating cuts—which save only small amounts of money in the short term anyway—are not reversed in fiscal year 2014, progress in the fight against TB will stall, and we’ll be paying tremendously for decades to come.”

Reaching the goal of zero TB deaths is well within our reach, but requires greater commitment by the Obama administration and Congress to support strong, sustained investment in new scientific advances to treat, diagnose, and prevent TB. Restoring funding for the TBTC is vital to stemming the TB epidemic and saving the lives of the millions affected by this disease.

Coco Jervis is Senior Policy Associate of the New York-based Treatment Action Group where she works towards significant improvements in domestic and developing countries’ overall health systems and continued support and effort to fight AIDS, TB and Hepatitis.

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