We Have the Technology to End Tuberculosis, but Do We Have the Will?

During the 22nd International AIDS Conference in Amsterdam, scientists, policymakers, healthcare workers, advocates, and civil society shed light on the relationship between HIV and other urgent health crises, such as Tuberculosis (TB).

A less known, but critically important fact: TB is one of the leading causes of death among people with HIV/AIDS worldwide. To effectively address HIV, budget and policy responses must reflect the challenge of HIV-TB co-infection.

In June, as the House and Senate Appropriations Committees considered their fiscal 2019 foreign assistance funding bills, there was encouraging discussion about the importance of fully funding the International Affairs Budget to maintain American leadership through diplomacy and global development.

We have had this role since the establishment of the Marshall Plan after World War II, and for many good reasons. American investments in global development have proved to be beneficial to us as well.

When we support countries’ efforts to strengthen their health systems and boost economic growth, we create market opportunities for American businesses through expanded trade. This small fraction of our federal budget also protects our national interests — for example — by preventing infectious disease outbreaks before they create chaos and devastate economies. Investing in global development also fulfills a moral imperative: saving millions of lives every year.

The case for U.S. leadership becomes evident when we look at the struggle against Tuberculosis. TB remains the leading infectious disease killer in the world, with two billion people — one third of the world’s population — infected with the disease. It mainly affects young adults in their most productive years.

On average, people fighting TB lose more than 50 percent of their income due to reduced productivity. Poverty and poor access to TB-related services complicates the treatment of those affected by TB. The additional social and economic losses on already struggling communities make it much more difficult for countries to grow their economies, foster shared prosperity and achieve self-reliance.

Although we have made much progress, gains are uneven: half of all new infections occur in a just a handful of countries. Drug-resistant TB is a major and growing threat; in 2016, there were 600,000 new cases worldwide. Further, The World Health Organization (WHO) estimates a $2.3 billion gap between current funding and what’s needed to carry out necessary interventions. While early diagnosis is key to preventing the spread of TB, for example, the required capacity to detect and treat the epidemic is lacking in many countries.

We have what it takes to defeat the epidemic. Better data shows where missing TB cases are, country by country. Partner governments, regional bodies, the World Bank, The Global Fund to Fight HIV, TB and Malaria — among others key actors — are committed to strengthening health systems to end TB.

Focusing on strengthening health systems continues to demonstrate powerful results. Estimates indicate that such efforts have saved 53 million lives between the 2000-2016 period, including people who are co-infected with HIV/AIDS.

This year, 2018, presents a unique opportunity to recommit to end TB. On September 26, heads of state, civil society and business leaders will gather in New York at the United Nations General Assembly for the first-ever UN High-Level Meeting on TB. This meeting should result in an ambitious political declaration that will reinforce action and investments to end TB.

As Congress considers the fiscal 2019 State and Foreign Operations appropriations, we urge Congress to support $302 million for the USAID TB program, as approved by the House Appropriations Committee. Sufficient funding, backed by leadership and effective interventions, may finally give us an edge over TB, and put countries on a path toward sustainability, shared prosperity, and self-reliance.