TB is closer than you think
Most people are shocked to hear that tuberculosis continues to exist across the world. While TB is preventable and treatable, it is not being prevented or treated in many developing and developed countries and remains a leading cause of deaths worldwide. Unfortunately, according to the World Health Organization, more than 10 million people get sick from TB annually, and 1.7 million people die from the disease each year.
While recent data shows that 95 percent of cases and deaths are in developing countries, TB cases continue to occur in the United States with more than 9,000 patients diagnosed annually. Notably, Texas is one of three states with the highest number of TB cases nationwide. As a busy international city for commerce, travel and tourism, Houston remains vulnerable to global health problems. Serious TB cases are diagnosed every day in Houston. At the Tuberculosis Clinic at Texas Children’s Hospital, physicians see over 20 children per week. Every year approximately 40 children in Houston become sick from TB, and 230 children are infected with the TB bacteria that require treatment to prevent them from becoming sick.
Drug-resistant TB has become a serious public health problem worldwide. In 2014, 480,000 people developed multidrug-resistant TB, which increased to 600,000 cases by 2016. Multidrug-resistant TB is very difficult and expensive to treat. Patients start on up to six medications for at least two years and only 50 percent of patients who receive treatment are cured. The average cost of treating a patient for multidrug-resistant TB is over nine times as high ($154,000 compared to $17,000) as patients with drug susceptible TB. Without continued attention and funding, it’s only a matter of time before physicians lack options to treat TB.
Through dedicated attention, focused expertise and improved funding, we have reduced the number of TB cases in our country. Efforts helping to eliminate TB in the United States and abroad must continue to sustain these efforts.
The United States continues to show excellent leadership in supporting TB treatment and research. In Congress, the Comprehensive TB Elimination Act of 2008 was bipartisan legislation U.S. Rep. Gene Green sponsored with former U.S. Reps. Heather Wilson, R-N.M, and Tammy Baldwin, D-Wis. The bill was signed into law by President George W. Bush. It provided funding for the Centers for Disease Control and Prevention to respond to international outbreaks of multi-drug resistant TB. It also increased funding for the elimination of TB. The law also expanded research on TB diagnostic and treatment tools at the CDC and National Institute of Health.
The Comprehensive TB Elimination Act provided the resources necessary to develop new tools to better diagnose TB infection and molecular tests that more accurately and rapidly identify resistant strains of drug-resistant TB. In addition, the first new TB drugs in the past 45 years (Bedaquiline and Delamanid) were recently introduced and are now being used to successfully treat patients with multidrug-resistant TB.
The United States has done an excellent job providing funding for global health. In the last few years, Congress has shown a commitment to funding medical research and combating disease outbreaks. The National Institute of Health received a $3 billion boost in funding, allowing new research that could lead to cures for ailments and disease that are increasingly difficult to treat. Our country has also been the largest contributor to the Global Fund to Fight AIDS, TB and Malaria, providing more than $4 billion in the past three years alone to help combat TB and other infectious diseases worldwide.
Despite the many challenges, there is cause for hope. Through tremendous effort, strong expertise, and improved funding, we have reduced the number of cases of TB. Yet more remains to be done to achieve the goal of ending the TB epidemic by 2030.
Green represents the 29th Congressional District of Texas and serves as the ranking member on the Energy and Commerce Subcommittee on Health and co-chair of the Congressional Tuberculosis Elimination Caucus. Hatzenbuehler is an assistant professor in pediatric infectious disease at Baylor College of Medicine and works in the Tuberculosis Clinic at Texas Children's Hospital.