On Sept. 26, 2018, the United Nations General Assembly will hold the first-ever High Level Meeting focused on ending tuberculosis (TB) globally. This is a critical opportunity for making global progress and working towards stopping this deadly disease in its tracks.
TB, which spreads from person to person through the air, is the leading infectious disease killer worldwide, claiming 4,000 lives a day. In 2017, there were 10 million TB cases. TB is like any infectious disease in that it respects no borders—in today’s interconnected world, TB anywhere is TB everywhere.
Further, drug-resistant TB poses a grave threat to the health and economy of the United States and countries globally. Recent estimates show that without accelerated action, multidrug-resistant TB (MDR TB) could claim 75 million lives and could cost the global economy $17 trillion in lost productivity by 2050.
In addition to the tremendous burden of active TB disease globally, a staggering nearly two billion people—approximately one fourth of the world’s population—have latent TB infection. People with latent TB infection do not have symptoms, do not feel sick, and cannot spread TB bacteria to others. However, without treatment, they are at risk for developing active TB disease and transmitting the bacteria to others. Preventive treatment of latent TB infection significantly reduces the risk of progressing to TB disease.
TB is personal for me. When we were growing up, after exposure in a high school setting, my older sister took nine months of treatment for latent TB infection to prevent the development of TB disease. TB disease can be prevented, if we find people infected with TB and treat them before they develop TB disease.
We have tools and technology to defeat TB, but we need global leadership and investments by other countries. The time is now for global actors, governments, key stakeholders, civil society, the private sector, faith-based organizations, and multilateral institutions to make bold global commitments to cure and prevent TB.
The United States has one of the lowest rates of TB in the world, thanks to continued investments in domestic TB programs. Over the last 20 years, U.S. public health efforts have prevented up to 319,000 cases of TB in the United States and averted up to $14.5 billion in costs. However, many people in the United States are still at risk for TB disease. Up to 13 million people in the United States have latent TB infection, and the U.S. continues to work to incorporate testing and treatment for latent TB infection in public and private health systems. This work to find people infected with TB and provide treatment for their TB infection can prevent them from developing active TB disease.
Evidence shows that preventive TB treatment can reduce the risk of developing active TB disease and save lives. This is especially important for vulnerable populations, such as children and people living with HIV, as TB is the leading cause of death among people living with HIV. Yet, in 2017, only 1 million people living with HIV and only 23 percent of eligible children received this treatment around the world.
The U.N. High Level Meeting targets on preventive treatment for TB are clear: Between 2018 and 2022, provide treatment to 6 million people living with HIV and 4 million children globally.
The Centers for Disease Control and Prevention (CDC) is on the forefront of efforts to expand TB preventive treatment. CDC, as part of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), is supporting the push to provide TB preventive treatment to 5 million people globally living with HIV by 2020, and is developing new tools for finding and treating eligible children. These efforts alone will move the world closer to meeting the High Level Meeting targets among people living with HIV.
Global health partners have technical experts developing new tools and approaches to better target our efforts, find and cure individuals faster, and prevent disease, especially in the most vulnerable populations. CDC is researching new diagnostics and treatments for TB, using our domestic experiences to inform and strengthen global efforts. CDC is committed to continuing the fight against TB in all its forms in the United States and around the world.
As a global community, we find ourselves at an important moment in the global fight against this curable and preventable infectious disease. The time is now for us to come together, be accountable, spur innovation and invest in cutting-edge science and programs to defeat TB here in the United States and around the world. Millions of lives are at stake.
Rebecca Martin, PhD, is director of the Center for Global Health, Centers for Disease Control and Prevention.