With global health threats, investing in health systems pays off

Updated April 10th, as published in the Duluth News Tribune

In 2014, there were 9,421 new cases of Tuberculosis reported in the United States.  Major diseases considered, this was a relatively low number, meaning that of the worrisome events 2016 may bring to your life, a positive TB diagnosis likely is not one of them.  Through a global lens, however, things get a little more common: One in every three people worldwide is infected with the tuberculosis bacteria.  March 24th was World TB Day.  Why should we care? 

The low incidence of a given disease is poor precedent to gauge American concern.  When Ebola ravaged West Africa in 2014, Americans infected by the virus remained in single digits.  Even so, the media’s frenzied response that followed was far from calm.  The U.S. eventually pledged $6 billion in aid to address the Ebola epidemic.  Two-thirds of thatcould have been estimated as preventable spending had robust health systems been in place. 

It makes sense to invest early in global health systems to prevent outbreaks of Ebola, tuberculosis, and other infectious disease.  Thankfully, portions of aid already have been earmarked for health workers and public health infrastructure. 

Tuberculosis is now the world’s leading infectious killer (1.5 million deaths in 2014), recently surpassing the number of deaths to HIV/AIDS.  In 2014, over 9 million people contracted Tuberculosis, according to the World Health Organization.

Unfortunately for humans, especially those that live on the margins of accessible health care, tuberculosis is a stubborn, hardy bug.  Once infected, the bacteria walls itself inside the body through various defense mechanisms, causing treatment challenges that require diligent medication schedules and long-term follow-up.  These traits have spawned resistance to medicines—labelled as "MDR-TB," or multpile drug resistant and "XDR-TB," or extensively drug-resistant—which leaves health professionals with few antibiotic regimens to combat resistant forms of the disease.  And without the treatment, outcomes are deadly.

An estimated 480,000 cases of MDR-TB occurred in 2014, but a paltry 123,000 were reported.  When fewer than half of new infections are being addressed, that’s recipe for disaster, and, worse, preventable human suffering.

So often health is considered as here or there rather than as its true nature: a global web of patients, governments, and civic societies.  Bacteria like tuberculosis travel along neglected health systems and medical structures that have the potential to affect communities well beyond where its patients, doctors, and nurses interact.  Whether in rural Minnesota or Haiti’s Central Plateau, health always will remain distantly and intimately connected.

Last year the White House released the "National Action Plan for Combatting Multidrug-Resistant Tuberculosis,” which aims to put 560,000 people on treatment in 10 high impact countries.  Full funding at $400 million to support USAID (U.S. Agency for International Development) tuberculosis programs in the upcoming fiscal year to galvanize that action plan, build robust health systems and respond to tuberculosis.

While World TB Day has come and gone, we can still celebrate by recognizing the interconnectedness of our health and by seriously addressing the risk tuberculosis poses. This stance requires action as opposed to reactions after future outbreaks arise.