Soapbox

We can wipe out tuberculosis

People pass a banner promoting Sierra Leone’s anti-Ebola campaign earlier this month. Ed Zuroweste says a similar effort is needed to eradicate tuberculosis worldwide.
People pass a banner promoting Sierra Leone’s anti-Ebola campaign earlier this month. Ed Zuroweste says a similar effort is needed to eradicate tuberculosis worldwide. The Associated Press

Earlier this month, California quietly ended Ebola monitoring for travelers arriving from West Africa after Liberia declared itself Ebola-free, following similar declarations in Sierra Leone and Guinea. Though Sierra Leone announced last week that it had identified one new case, the global community has declared an end to the West African Ebola outbreak.

Ebola has been snuffed out because of a swift and well-funded worldwide public health response. Like California, many states and nations imposed strong monitoring. Others fought the disease at its source; clinicians from many countries, like me, went to Africa to help build infrastructure and train clinicians. While the 11,315 reported deaths have shattered communities, the response prevented a much larger crisis.

Imagine if we repeated this level of worldwide action with tuberculosis.

In the next three days, more people will die from tuberculosis worldwide than died from Ebola during the entire two-year outbreak. And most TB infections are – unlike Ebola – curable. In Africa, six months of medication to treat a typical case costs just $10.

According to the World Health Organization, more than 2 billion people worldwide are infected – that’s one in three humans carrying a kind of sleeping TB that is not contagious, but will reactivate in almost 10 percent during their lifetime. Each year, this translates to about 9 million people having active TB, which is highly contagious. Unlike Ebola, where physical contact with a sick person is needed to contract the disease, TB is airborne. If a person with active TB coughs and you enter the same room an hour later, you are at risk.

Then there are the terrifying, increasingly common strains of TB that resist standard drug treatments. These mutations – a result of inadequate treatment – are already showing up in the United States; in 2011, about 10 percent of cases were resistant to antibiotics and 50 people with drug-resistant TB died.

Tuberculosis is a greater public health threat than Ebola not only in developing countries but also in America. This month’s outbreak in Alabama, where the TB rate is currently worse than that in many developing countries, highlights that vulnerability.

If we don’t act, we’re likely to see TB’s scary mutations as epidemics in the future. To prevent that, we need to appropriately treat the 9 million cases of active TB every year and cure them, and we need to identify people who are infected with inactive TB and put them on preventive therapy. We need funding to develop an effective vaccine and quicker treatment. And we need the political will to take these goals seriously.

At the end of December, the Obama administration released its National Action Plan to combat antibiotic-resistant bacteria, including tuberculosis, but it lacks funding. While Ebola and TB are different, I learned through my work in West Africa that where there’s attention and money, doctors can slow down major health crises like Ebola. Let’s act on TB with the same urgency.

Ed Zuroweste, who consulted for the World Health Organization during the Ebola outbreak and runs tuberculosis clinics in Pennsylvania, is chief medical officer of Migrant Clinicians Network, based in Austin. He can be contacted at ezuroweste@migrantclinician.org.

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