With health services out of reach and unprepared to meet public health crises, an impoverished population more familiar with stigma and exploitation than with medical care and cures, the tuberculosis outbreak reported by the New York Times last week reads like a familiar dispatch from a distant and resource limited setting in need of support from wealthier and more developed countries. In fact, the article points out, the outbreak in the rural southern United States that it describes is worse than those in “many developing countries.” The obstacles to health and the conditions fueling the spread of disease that the article describes, in turn, are the same, a statement from United Nations Special Envoy on Tuberculosis Dr. Eric Goosby pointed out. The outcome also is the same, noted Goosby’s statement, which followed the last week’s New York Times article: “TB takes lives that can easily be saved.”
Goosby notes that the Alabama county described in the Times article is one of many, in the region, in the United States, and in the world where resources needed for the public health efforts that tuberculosis demands are not available. He also urges that when, in the next few weeks President Obama proposes spending priorities for the next fiscal year, and in the months that follow as Congress weighs them, they think about Alabama’s tuberculosis outbreak, and remember that a global health issue is an American health issue.
Goosby’s statement voices concerns also delineated in a letter to the White House from 14 U.S. Senators the day before, reminding President Obama that this country was home to more than 9,000 tuberculosis patients in 2014. Defeating the disease, they note, will require not only collaborative strategies, but the funding to make them happen. The letter, signed by Senators Sherrod Brown, Ed Markey, Brian Schatz, Barbara Mikulski, Sheldon Whitehouse, Ben Cardin, Mazie Hirono, Barbara Boxer, Jeff Merkley, Robert Menendez, Christopher Murphy, Gary Peters, Ron Wyden, and Charles Schumer, begins as a thank you note for the Obama administration’s plan, released at the end of 2015, to combat drug-resistant tuberculosis. But, echoing global TB advocates in the days following the plan’s release and Jan. 11 “launch”, they note that “the activities described in the National Action Plan are all contingent on receipt of the funding necessary to implement those programs and strengthen those efforts.”
The plan sets goals, (some, by the time the plan was released, already within reach) to ensure improved TB treatment coverage in some of the hardest hit countries, but does not specify time targets for research and development goals, which include more effective and less toxic treatments and improved diagnostic tools. The Obama administration has proposed reductions in spending on tuberculosis programs in each of the last three years, proposals that have been rejected by Congress each time.