Today the US Centers for Disease Control and Prevention (CDC) released new data showing that tuberculosis is on the rise throughout the US for the first time in over two decades. Twenty-nine states and the District of Columbia registered an increase in TB cases from 2014 to 2015. This is the first reported increase in the number of people who contracted TB disease in the US since 1992.
“These numbers are worrisome because we’re looking at a potential resurgence of TB in the United States. We’ve seen slow but steady progress against TB over the last twenty years, and unfortunately that has bred complacency when it comes to making sure health departments have adequate resources to help TB patients and to stop transmission,” said Dr Paula I Fujiwara, Scientific Director of the International Union Against Tuberculosis and Lung Disease, and a former CDC medical officer.
In 2015, 9,564 people in the U.S. developed TB disease, an increase of 154 cases from 2014, according to new CDC data published today.
In order to restore the progress towards global and domestic TB elimination, it is essential to focus on prevention. A renewed prevention campaign will help to identify latent infections and, in turn, treat them before these cases become active and contagious. But first, there needs to be adequate funding for prevention efforts. Elimination is not possible without preventing active cases.
“We can’t safeguard the public health from TB without adequate staff and capacity to perform essential activities,” said Donna Wegner, Executive Director of the National TB Controllers Association. “What the increased numbers may indicate is that we have reached the limit of what can be accomplished with the current resources. More robust funding to support a comprehensive prevention initiative is critical to put the US back on track to end TB. With greater funding, TB programmes can shift from a reactive stance to proactively protecting the public health. Using local epidemiology to screen those at highest risk for TB and treating those infected successfully prevents future cases and transmission and saves money.”
In the 1980s and 1990s, the US experienced a TB epidemic that arose as a consequence of Congress eliminating federal funding for TB activities. As a CDC medical officer assigned to New York City, Fujiwara led the response to the worst outbreak of multidrug-resistant TB in US history.
“That epidemic cost about a billion dollars to stop, which was far more expensive than it would have cost to prevent in the first place. It was avoidable,” said Fujiwara.
“MDR-TB emerges when we don't ensure that standard TB is adequately treated and prevented. MDR-TB is a human-made problem,” said Fujiwara, “and failures in funding, leading to failures in systems, are central to its emergence.”
A new study published this month in the US showed that extensively drug-resistant TB has by far the highest hospital costs of all health conditions.
Despite recently rolling out a National Action For Combatting MDR-TB, The White House’s 2017 Federal Budget proposal includes a proposed 19% cut for TB funding—amounting to $45 million.