By Eric Goosby, MD
TB is officially the stepchild of infectious diseases and we must take action now to turn the tide. It defies logic that a curable disease kills more people than any other infectious disease on the planet.
According to WHO's new Global Tuberculosis Report, in 2015, 1.8 million people died from TB, up from 1.5 million in 2014. Incidence also rose from 9.6 million people to 10.4 million. Part of the increase can be attributed to better reporting from India. And while improved reporting is worth commending, it does not change the fact that we are heading in the wrong direction with this centuries old disease.
To effectively turn the tide we must focus our efforts on strengthening detection, improving diagnostics and bringing more tolerable drugs to market. Most of all, we need the resources to take these steps. Investing in efforts to defeat TB is smart, saves lives and is cost effective.
Now more than ever, the world needs a concerted TB effort. We must reengage donors and donor nations and demonstrate how an investment in TB is an investment worth making. We must encourage countries plagued by TB to own and fund taking care of their own people. They won't be alone in financing programs, particularly in low-income countries, but they must step up to the plate.
We cannot discuss TB without tackling the growing problem of drug resistant TB (DR-TB). According to WHO, of the 580,000 cases of DR-TB estimated to have occurred in 2015 only about a quarter of these—125,000—were detected and reported. Furthermore, of those who do start treatment, only about half will successfully complete the course. The longer those patients with DR-TB remain undiagnosed and untreated, the greater the potential that they will transmit the infection to family, neighbors, people on a bus or in the clinic waiting room. Unless measures are taken to ensure earlier identification and prompt initiation of effective treatments for persons who become ill with DR -TB, the global impact will be devastating.
Last week, USAID released its progress report on the December 2015 National Action Plan on Combating Multidrug-Resistant TB. The report validated the call for scale up of existing programs and the need to support research to spark better drugs and diagnostics. I hope that this report gets the necessary resources from the next Administration to ensure action is taken to defeat this deadly disease. Generously funding the Plan will send a strong signal to the world that combating TB is a serious concern for our country.
Funding efforts to put us on the path to defeating TB will also put us on the path to achieving global universal health coverage (UHC). You cannot get to a place where you achieve the central tenets of UHC including financial risk protection, access to quality essential health-care services and use of safe, effective and affordable essential medicines without a strong commitment to ending TB. And if we don't eliminate not only TB, but HIV/AIDS and malaria as well, we will never win the battle against non-communicable diseases such as heart disease, diabetes and hypertension.
Finally, perhaps the most alarming statistic in the 2016 TB Report is not the increase in cases, which reflects a better understanding of the epidemic, but the fact that case detection and reporting is virtually flat. With nearly 40% of the cases undetected and unreported we need to acknowledge the massive challenge that TB will represent to our health systems.
We have made great progress in defeating AIDS and malaria, but our commitment to fighting TB has fallen far short. It is ironic that of the three major infectious diseases, the one that has a cure is the one left behind. Drug sensitive TB is curable almost 90% of the time with current treatments.
We must turn the tide. We must break down barriers to accessing care. And we must fund efforts that will make our goals achievable. Without these actions, nearly 5,000 people will continue to die every day from TB. That is simply unacceptable.
Eric Goosby is UN Special Envoy on Tuberculosis and director of Global Health Delivery and Diplomacy at UCSF Global Health Sciences. This post originally appeared in the Huffington Post as part of the 'Fighting Tuberculosis' series.