On World Tuberculosis Day, Time to Step Up the Fight

Let's face it: despite the valiant efforts of many actors over the past decade, progress in the fight against tuberculosis remains alarmingly slow.

But today, to mark World Tuberculosis Day, the World Health Organization is focusing on pragmatic steps that offer hope. The theme they've picked is: "On the move against tuberculosis: innovate to accelerate action."

Though innovation is only part of the answer, it's an appropriate theme. Right now, because of slow progress against the disease TB infects approximately 8 million and kills nearly 2 million people every year. Most of these deaths occur in developing countries. (See this shocking map to better understand the global distribution of TB.)

Perhaps most troubling is the rise of multi-drug resistant cases of TB (MDR-TB), which don't respond to basic first-line antibiotics and require more expensive and lengthy treatment. In recent years, extensively drug-resistant forms of TB (XDR-TB) have also emerged, threatening to put us back into a "pre-antibiotic" era, in which our best drugs are obsolete.

Indeed, as Te-Ping covered last week, the WHO announced last week that the number of patients with these drug-resistant forms of TB are at their highest levels ever. The world is failing to keep up in the fight: each year, only 1% of the approximately 500,000 new cases of drug-resistant TB receive treatment.

In a hopeful sign, TB mortality incidence has declined over the past decade. Yet expanding drug resistance (not to mention TB co-infection among HIV/AIDS patients) could eliminate such progress.

How can we avoid such a future? Anti-TB campaigners are focusing on two major fronts:

• Investment in innovation for drugs and diagnostics. The last new drugs for TB were produced as long ago as the 1960s! Research and development for TB diagnostics has similarly stalled, making it difficult to keep pace with rapidly evolving bacteria. Recent initiatives, led by Eli Lilly, the Gates Foundation (and others), promise to yield important new tools. Sustained philanthropy for such research and discovery is necessary for a disease that affects populations with almost no purchasing power or profit-making potential.

• Expanded funding for diagnosis and treatment delivery. Significant funding gaps continue to plague global TB efforts. For example, the Global Fund for HIV/AIDS, TB and Malaria -- a main international funding body for TB treatment -- is faced with significant funding shortfalls each year, due to broken pledges by donor nations. The Obama administration's FY2011 budget for global health not only cuts funding for the Global Fund, but also slashes TB funding overall. (For more on this, see Joanne Carter's work in the Huffington Post.) The campaign for increased TB funding will be vital in providing access to basic treatment, as new tools may well still be years away.

Mobilizing on these two fronts may well help bring hope to the millions each year that suffer from TB. Unfortunately, tuberculosis right now is "on the move" faster than we are keeping up. To learn more and get involved in efforts to fight TB, check out the WHO's featured actions here, and remind your friends (via Facebook and Twitter) that 5,000 people will die of TB today unless we accelerate action!

Photo Credit: erix!