With the resources allotted to fight tuberculosis worldwide inadequate to demands of a pandemic complicated by drug-resistant strains and the impact of HIV globally, the United States will need to better lead, coordinate, focus and prioritize its efforts, or risk seeing domestic and international goals compromised.
That is among the conclusions of a summary report on A Strategic Approach to Global Tuberculosis released by the Center for Strategic and International Studies today, and the challenge that leaders of three agencies responding to TB discussed in the first of a series of panel discussions at the Center this morning.
The summary report was the product of a year-long examination of U.S. approaches to global TB that sought to identify critical needs in confronting multidrug resistant TB, the impact of HIV and TB coinfection and limited resources. It identifies at least four U.S. interests and efforts that a growing global epidemic of drug-resistant tuberculosis will weaken:
- efforts to combat domestic outbreaks of TB;
- the continued economic development of countries critical to global prosperity;
- the success of the new Global Health Security Agenda, a plan to strengthen the readiness of countries around the world to prepare for, identify and respond quickly to potential pandemic health threats;
- the success of the President’s Emergency Plan for AIDS Relief, the landmark and now decade old U.S. global HIV response.
All of these are endangered by a budget that does not support the efforts needed to confront challenges that include failures to diagnose and treat three million people annually, to appropriately and completely treat those who are identified, and to address the resulting spread of drug-resistant disease, panelists representing the United States Agency for International Development, the U.S. Centers for Disease Control and Prevention, and the President’s Emergency Plan for AIDS Relief agreed.
“The challenges we face are really growing in urgency and complexity,” noted Dr. Tom Kenyon of CDC. By urgency, he added, he meant, “before they grow beyond our ability to control, and I think that’s a realistic possibility.”
At the same time, Julia Martin of PEPFAR noted a frustration she has seen in her work with the Global Fund to Fight AIDS Tuberculosis and Malaria. While the new funding model encourages approaches that fight HIV and TB together, countries have been reluctant to do that.
And yet, she added, more integrated, better coordinated services — making TB treatment available in the same places antiretroviral treatment is made available — is critical to curtailing the reach of TB, and to making HIV responses more effective.
At the same time, the U.S. budget could be said to reflect a similar disconnect, the panelists’ comments indicated.
“I would acknowledge there is a gap in funding,” Robert Clay, USAID Deputy Assistant Administrator for Global Health said, adding that funding shortfalls have not fulfilled the vision of the act reauthorizing U.S. efforts against HIV, TB and malaria.
Stay tuned – Science Speaks will continue to cover the discussions and the full report Tuesday.