March 24, 2000, Friday 3 STAR EDITION
SECTION: A; Pg. 36
HEADLINE: Tuberculosis remains a dangerous global problem
SOURCE: Staff
Mention of the plague conjures up a dark chapter out of medieval history, right? Or
perhaps a scary chapter out of an uncertain and dangerous future of science fiction or
terrorist threats?
For a dose of reality, try the present and try tuberculosis, a disease many of us
thought had been relegated to the proverbial dustbin of history. Not to sound too
alarmist, but TB, experts tell us, will kill more people around the world this year than
in any year in history.
As alarming to public health professionals are the new tricks TB has conjured up due to
poor and inadequate treatment programs that have spawned some new, multidrug-resistant
strains. An epidemic outbreak in New York City in the early 1990s, for example, turned the
normal months-long regimen of drug treatment into a costly, years-long nightmare.
Even with those words, some will continue to think there is no reason to tune in to
this problem. They are wrong.
For starters, 80 percent of TB's 2 million to 3 million victims a year are taken
between ages 15 and 49, their most productive years as contributing members to society and
national economies. One way or another that's costing us all money.
An article in U.S. News & World Report's March 27 issue details how America's
porous borders are bringing the threat of the dreaded disease home to America. It's a
global problem that cannot be isolated.
"Clearly," says Helen Gayle of the U.S. Centers for Disease Control, "we
declared victory too soon."
Were TB some new and untreatable plague, the inadequacy of the global response might be
more understandable.
However, a strategy for detection and treatment of TB called DOTS (Directly Observable
Treatment, Short-Course) is already available for about $ 20 to $ 100 per case. Worldwide,
though, only about one in five people who are sick with TB are receiving DOTS.
The U.S. House of Representatives directed the U.S. Agency for International
Development to increase TB control programs' funding from about $ 12 million to $ 35
million in fiscal year 2000. That kind of commendable commitment will have to be continued
and built upon, say experts.
Whether the political questions involved can get sorted out is, of course, a matter for
debate.
But the problem is not someone else's. It is everyone's, and everyone should become
more acquainted with the stark realities involved.