PRESS RELEASES

U.S. Increases Funds for Combating Drug-Resistant Tuberculosis:

Global epidemic rate levels off, report says, but number of cases rises

By Cheryl Pellerin
USINFO Staff Writer

March 26, 2007

A woman takes tuberculosis tablets at a clinic in Durban, South Africa. (© AP Images)

Washington – The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is increasing its contribution to the global fight against tuberculosis (TB), the airborne infectious disease that is especially deadly to people whose immune systems are compromised by HIV/AIDS.

The rate at which people developed TB in 2005 was level or even declined slightly compared to 2004, according to the biannual World Health Organization (WHO) Global Tuberculosis Control Report released March 22, but the actual number of TB cases continued to rise slowly because the world population is expanding.

A serious barrier to TB control worldwide is a form of the disease called extensively drug-resistant TB, which can develop when some treatment drugs are misused or mismanaged.

“PEPFAR takes the issue of extensively drug-resistant TB very seriously,” U.S. Global Aids Coordinator Ambassador Mark Dybul told members of the House Foreign Affairs Subcommittee on Africa and Global Health March 21. “In response, we have increased the fiscal year 2007 commitment for TB/HIV efforts by providing $50 million more than originally planned.”

“Almost 60 percent of TB cases worldwide are now detected and out of those the vast majority is cured,” said U.N. Secretary-General Ban Ki-moon in a March 22 statement. “Over the past decade, 26 million patients have been placed on effective TB treatment thanks to the efforts of governments and a wide range of partners. But the disease still kills 4,400 people every day.”

More than 8.7 million people had TB in 2005. WHO estimates that 1.6 million people died of TB that year, and 195,000 of them were co-infected with HIV.

THE DISEASE

TB spreads from person to person like a common cold, usually through coughing. According to WHO, one in three people in the world is infected with dormant Mycobacterium tuberculosis, the TB bacterium. The bacteria become active when something reduces a person’s immunity – advancing age, or medical conditions such as HIV.

TB that is not resistant to drugs can be treated with six months to nine months of doses of the most effective, or first-line, drugs, like isoniazid and rifampin. Such treatment cures more than 95 percent of patients. But, because people in many resource-poor countries do not have access to treatment, nearly 9 million people develop TB each year.

“TB that is resistant to at least isoniazid and rifampin is called multidrug-resistant [MDR] TB,” said Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention (CDC), in testimony before the subcommittee. “MDR-TB requires treatment for 18 to 24 months with second-line drugs that are much less effective, poorly tolerated by the patient and far more costly.”

Many countries with a high TB burden find it impossible to treat MDR-TB patients because of the cost of drugs and the sophisticated laboratory services and intensive support required to administer them. Extensively drug-resistant TB is a subset of MDR-TB caused by bacteria strains that are resistant to first- and second-line drugs.

U.S. CONTRIBUTION

“The United States is on the front lines of the battle against TB,” Kent Hill, assistant administrator for global health at the U.S. Agency for International Development (USAID), told the subcommittee. “Between 2000 and 2006, USAID provided about $500 million for TB programs worldwide. Our ... 2006 funding level was about $90 million, which supported bilateral TB programs in 37 countries.”

USAID TB efforts are coordinated closely with those of other U.S. government agencies, particularly the CDC and Office of the Global AIDS Coordinator.

“On research,” Hill said, “we also work closely with CDC and the National Institutes of Health [NIH], particularly in operations research to improve program implementation, and in new drug development.”

In September 2006, Gerberding said, CDC, WHO and other members of the Stop TB Partnership, a network of international organizations, countries, public- and private-sector donors, governmental and nongovernmental organizations and individuals, developed an action plan on extensively drug-resistant TB.

As an initial step, the U.S. Federal TB Task Force is discussing a domestic and international response plan for U.S. government agencies on extensively drug-resistant TB and participated in the WHO Global TB Task Force that issued a global plan to respond to extensively resistant TB.

The White House will convene an interagency meeting in the next few weeks, she said, to ensure that U.S. government activities are integrated in a unified strategic approach.

“WHO is highly appreciative of the substantial financial support provided by the U.S. government annually for TB control since the late 1990s to affected countries, WHO, the Stop TB Partnership and technical partners, said Dr. Mario Raviglione, director of the WHO Stop TB Department. “In addition, the NIH is a major source of finance of TB research today.”

Related Stories:

• United States Marks World Tuberculosis Day, March 24.
• The full text of testimonies submitted to the March 21 House Foreign Affairs Subcommittee on Africa and Global Health is available on the panel’s Web site.
• A TB fact sheet and the full report are available on the WHO Web site. The report is available in Arabic, Chinese, English, French, Russian and Spanish.
• More information about tuberculosis is available at the National Institute of Allergy and Infectious Diseases Web site.
• For more information on U.S. policy, see Health and HIV/AIDS.

(USINFO is produced by the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)