Don’t Play Catch-Up With TB

Three years ago the World Health Organization declared a global emergency over tuberculosis, the Earth’s deadliest infectious killer. Several foreign countries surpassed the United States in reacting to the warning and to WHO pleas for money to fight the disease. For the sake of public health in both the United States and abroad, Americans should take forceful steps now.

Once known as consumption for its power to eat away healthy lung tissue, TB has infected 2 billion people, one-third of the world’s current population. Deaths from the disease--primarily in Africa and Asia--are running at a rate of 3 million a year. By the year 2000 the toll is expected to rise to 4 million a year.

To most Americans, the threat of TB appears remote. Last year there were only about 23,000 cases across the United States. Although this is a minuscule fraction of the global total, there is no cause for U.S. public health authorities to be complacent. Indeed, they were caught napping in the mid-1980s when a seven-year upswing in TB cases began.

Tuberculosis is spread through airborne bacteria. Studies show that one victim typically infects as many as 15 others, quickly transmitting the disease in the absence of strong preventive actions. Half measures in treatment may only encourage new drug-resistant strains. It’s crucial to stop the infection through vigorous treatment and then monitor victims for substantial periods. Health experts call this approach “directly observed treatment,” or DOT, and it’s the cheapest, most effective approach.

WHO estimates that the cost of DOT medications averages only $11 per person for six months. Tuberculosis is a problem that will not wait. If this global scourge is to be checked, the international organization needs help immediately.