Over the first 15 years of this century, as efforts against the “big three” global infectious diseases — HIV, malaria and tuberculosis — accelerated, the numbers of new HIV infections dropped by 32 percent, and the number of deaths caused by the virus declined by 31 percent. Malaria infections dropped by 18 percent, and deaths from that disease went down by 48 percent. Efforts to control tuberculosis were not nearly as successful, a recently released report from the Center for Strategic and International Studies notes, with new cases globally dropping by about 1 percent, and deaths — not counting the numbers of tuberculosis-related deaths among people with HIV — falling by 22 percent.
Reasons for the difference in advances against the first two diseases, and inroads against tuberculosis can be found in challenges specific to the airborne disease that has spread increasingly in treatment resistant forms, thrives in resource-limited environments, and infects an estimated two billion people or more in its latent form, the report notes. But, the authors point out, reasons can also be found in marked differences between U.S. responses to the three diseases. The report cites opportunities to improve success against tuberculosis by looking at the particular threats it poses, and how responses to the disease have lagged.
For one thing, the authors, Phillip Nieburg and Audrey Jackson of CSIS, note, while efforts against malaria and HIV have both been coordinated by high-profile, executive-branch based U.S. government initiatives (the President’s Malaria Initiative and the President’s Emergency Plan for AIDS Relief), responses to tuberculosis have not enjoyed that prominence, or benefited from the focus that accompanies that attention. The authors recommend that the White House appoint an official responsible for leading a presidential initiative leading U.S. global responses to TB.
In addition, the authors write, while the spread of multidrug-resistant and extensively drug-resistant TB — tuberculosis that does not respond to the first, or even subsequent lines of treatment — exemplifies the growing challenge of antimicrobial resistance that has been recognized with both global and domestic response plans, the disease has a relatively low profile in plans at both levels. Recognizing, and correcting that disparity would lead to more effective responses, and also to more appropriate resources to carry out strategies currently going unfunded.
In turn, the initiative leading U.S. efforts against global tuberculosis should be regularly and independently evaluated for their effectiveness.
The complete report can be downloaded here.