In a Shrinking World, Disease Anywhere Means Disease Everywhere

Every year, the United States spends more than $230 million immunizing its citizens against a disease, polio, that was eliminated in this hemisphere in 1994. But because polio still can be found--some 5,000 current cases--in other parts of the world, immunizations here must continue.

This is just one example of the heavy cost that international infectious diseases impose on Americans, the subject of our committee’s hearing today. Additional costs are incurred from strengthened pathogens that are resistant to drugs. For example, in the U.S., it normally costs $2,000 to treat a patient with tuberculosis. But that cost may be 100 times higher if the patient has drug-resistant TB.

As a result of the underuse of antibiotics in the developing world and the overuse in the developed world, viruses are developing stronger strains that are able to overcome standard antibiotics. A report by the World Health Organization released last week indicated that “almost all infectious diseases are slowly but surely becoming resistant to existing medicines.”

These new, troubling developments come as our global economy and advancing technology make the world a smaller place. Last fall’s outbreak of West Nile virus in New York state, which resulted in 62 cases of encephalitis and seven deaths, was the first time that the West Nile virus was identified in the Western Hemisphere. The appearance of the West Nile virus in dead crows found in New York and New Jersey in recent weeks means that federal, state and local authorities in Connecticut, New York and New Jersey once again must undertake comprehensive mosquito control measures to prevent another outbreak.

With one out of every two deaths in the developing world attributed to infectious diseases, the threats to economic growth and political stability are even greater there. In Zimbabwe, a pivotal country in southern Africa, political instability combined with an alarmingly high HIV infection rate--25% of women at some urban clinics test positive--threaten to destabilize the entire continent.

The House of Representatives has taken action by passing bipartisan legislation that would authorize $500 million over five years for a World Bank AIDS trust fund. Yet much more needs to be done. Acute respiratory infections, such as pneumonia, kill 1 million more people each year than does AIDS. Four other killers--diarrheal diseases, tuberculosis, malaria and measles--combine with AIDS and respiratory infections to account for 90% of total infectious disease deaths worldwide.

While there has been vigorous political debate about the role the U.S. should play in multilateral issues such as peacekeeping and the international criminal court, we can be much more unified on the international public health crisis. The simple truth is that the United States cannot go it alone in the fight against international infectious diseases.

The WHO has estimated that the international community needs to commit $1.5 billion per year over the next 10 years for the medicines and prevention tools to stop the spread of the “Big Six” killer infectious diseases. The U.S. already is the world’s major contributor to the WHO and other international health organizations. We must continue that commitment, urging our allies to follow our lead.

Next month, the heads of state of the world’s seven largest economies and Russia--the G-8--will gather in Okinawa, Japan, where infectious diseases will be one of the primary issues. It is imperative that concrete policies be put into place now. For instance, educating health care workers about the appropriate use of anti-microbial drugs, as the WHO has recommended, will cost little but have an enormous impact. Increasing funding for research into new drugs and vaccines will pay dividends for generations to come.

Attention from the G-8 is important and laudable, but the developing world must be brought into the discussions as well. This can be fostered by the WHO and the rest of the United Nations, a cause that everyone in Washington can support.