Posts Tagged ‘US government TB strategy’

During a live interactive webcast today hosted by the Kaiser Family Foundation, an expert panel agreed that tuberculosis poses a grave global health threat and demands an innovative, multifaceted response—from new drugs to scaled-up treatment to better infection control.

The lively forum, available here, highlighted the need for an aggressive approach to the global tuberculosis epidemic just as the US government is putting the finishing touches on its five-year global tuberculosis strategy. But it’s far from clear the US will provide the leadership and resources needed.

Cheri Vincent, senior public health advisor in the Infectious Diseases Division, Bureau for Global Health, at USAID, said her agency is now mapping out its five-year TB strategy, working in conjunction with PEPFAR, the Department of Defense, and other agencies. One key objective, she said, is to halve TB prevalence by 2015 from 1990 levels. Another goal is to get at least 90,000 patients with multi-drug resistant TB on treatment, she said, noting that right now, very few MDR-TB patients are being treated in adherence with international guidelines.

“We also need to build on the health system platform and make sure we’re doing it in a cost effective and integrated approach,” Vincent said.

Christine Sizemore, Ph.D., chief of the Tuberculosis and other Mycobacterial Diseases Section in NIAID’s Division of Microbiology and Infectious Diseases, noted that in 1985, the research institute’s budget for TB was only $160,000 a year and the disease had fallen off the medical community’s agenda. It popped back up in the 1990s, when an outbreak of drug-resistant TB in the U.S. made scientists realize this was a continuing threat.

Now, she said, the National Institute of Allergy and Infectious Diseases has made a “fairly significant investment” in TB, spending about $140 million a year on TB related research. But, Sizemore said, “We need to start looking at the disease in a larger context.” She said discussions are underway to move toward what NIAID director Tony Fauci has called a “transformative” research agenda for TB. For more on Fauci’s vision, read this post.

Christine Lubinski, director of the IDSA/HIVMA Center for Global Health Policy, said while these steps are vital, the US government’s response still does not reflect the urgency of the epidemic. She noted that when Congress reauthorized the global AIDS initiative, known as PEPFAR, in 2008, lawmakers authorized $4 billion over five years for TB control, but decision-makers are not on track to fulfill that funding commitment.

In the last budget proposal from the White House, “we did not see … even remotely a down payment on that,” Lubinski said. (more…)

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