This World TB Day, tuberculosis is still a global threat

I only knew my Uncle Jimmy through pictures.

When I was a young child growing up in the 1940s and 1950s, he lived away from my Aunt Peggy and cousin, Jeannie, in a sanitarium in New York because he was sick with tuberculosis (TB).

The disease is contagious and without any effective treatments back then, people were quarantined in sanitariums.

Jeannie was only 18 months old when her father was diagnosed with TB, and she has vague memories of him coming home from the hospital at Easter and Christmas. On visits to the sanitarium, Aunt Peggy would don a mask and go inside while Jeannie waited outside because she was too young to enter. Jeannie has warm memories of her dad coming out to the balcony to wave and smile at her.

Uncle Jimmy died on April 10, 1950 at the age of 34.

{mosads}More than 60 years later, people in the U.S. and around the world are still dying from the same disease that killed my uncle. There is a public perception that tuberculosis is a disease of the past that has been cured, but statistics show this is completely false. In 2014, 1.5 million people died from the disease globally, 9.6 million developed active tuberculosis and of those cases, an estimated 480,000 are categorized as multidrug-resistant (MDR) or extensively drug resistant (XDR), which makes the disease particularly deadly because those strains don’t respond to traditional drug treatments.

Thanks to public education campaigns over the years, the average person walking down the street in the U.S. probably has a general awareness of the causes and effects of HIV/AIDS, and red ribbons are a universally recognized symbol for the disease. Sadly, the same cannot be said about TB or World TB Day, which takes place on March 24. Tuberculosis is among the most lethal infectious diseases in the world and kills one person every 21 seconds, according to the World Health Organization (WHO), and yet a large segment of the public is unaware of the threat level it poses.

Tuberculosis is primarily an airborne disease spread through microscopic droplets that accompany everyday actions such as speaking, sneezing, coughing, laughing or singing. Tuberculosis spreads most easily where people spend time in close contact with each other. Tuberculosis reports in the U.S. in recent years have been linked to places with large concentrations of people such as middle and high schools, colleges, large companies, hospitals and in July 2015, a county fair in California. People with compromised immune systems are particularly susceptible to TB, and about a fourth of people who die from TB also have HIV/AIDS.

Although the TB vaccine for infants is the most widely used in the world, it’s only moderately effective and doesn’t adequately protect teens and adults who are most at risk of developing and spreading TB. For those with active TB, treatment lasts for at least six months and includes an arduous drug regimen of daily pills that often require directly observed consumption to ensure treatment adherence. In the U.S., it costs an average of $17,000 to treat and care for a single patient with drug-susceptible TB and an average of $430,000 for XDR-TB treatment. The side effects of TB treatment can be painful and long-lasting, and in some cases can lead to permanent hearing loss.

Despite the dangers of TB, not enough money has been invested in research and development (R&D) to accurately diagnose, treat and search for a vaccine to prevent the disease. Tuberculosis was recently included on the U.S. Department of Defense’s annual budget request as part of its Congressional Directed Medical Research Program (CDMRP) Peer Reviewed Medical Research Program (PRMRP) list of diseases. American servicemen and servicewomen are stationed in many parts of the world with high rates of TB disease, particularly in places with MDR-TB and XDR-TB, which have been reported in more than 105 countries. As our military men and women return to the U.S., and global travel increases among civilians, the risk for TB transmission and outbreaks is extremely concerning. Without more research into developing new vaccines and treatments to combat the drug-resistant strains of TB, outbreaks could lead to drug shortages, economic losses and fatalities.

A single country, government or institution cannot do this alone. We need to unite as a global community to encourage policymakers and funders to make TB a priority and devote more funding to vaccine technologies and treatments. Five-year planning by the Stop TB Partnership calls for $1.25 billion for vaccine R&D. While the final goal of a new vaccine may take 10 years, even doubling that number pales in comparison to the $8 billion annual cost the WHO estimates it takes to fully treat the TB epidemic. 

Tuberculosis is one of humanity’s oldest diseases. We shouldn’t leave this to future generations to solve when we can take action now. I look forward to the day when families like mine no longer have to bury loved ones due to TB and we can put an end to this terrible disease.

Gingrey, M.D., is a senior adviser at the District Policy Group, a boutique policy and lobbying practice within Drinker Biddle & Reath. Dr. Gingrey is a former U.S. congressman who served Georgia’s 11th congressional district from 2003 to 2015. The views expressed are the author’s own and are not an endorsement of the legislation mentioned.