March 24, 2017

Tackling TB: How the U.S., the Global Fund, and PATH are Helping Wipe Out a 4,000-Year-Old Disease

By Elizabeth Holtan

Click here to view the original post on Medium.

On March 24, 135 years ago, a German doctor named Robert Koch announced that he had discovered the cause of tuberculosis, known at the time as consumption.

The tiny Mycobacterium tuberculosis was responsible for some pretty terrifying statistics. “If the importance of a disease for mankind is measured by the number of fatalities it causes,” Dr. Koch told his audience, “then tuberculosis must be considered much more important than those most feared infectious diseases: plague, cholera, and the like. One in seven of all human beings dies from tuberculosis.”

Today, TB is still one of the world’s deadliest diseases. 10.4 million people (that’s more than the combined populations of Mississippi, Colorado, and New Mexico) became sick with it in 2015, resulting in nearly 2 million TB-related deaths around the world.

Tuberculosis is spread through the air from one person to another when someone with active TB in his or her lungs coughs or sneezes. Symptoms include coughing, fever, weight loss, hemoptysis (coughing up blood), and chest pain. Many people carry the bacteria with no active infection or symptoms, however — these cases of latent TB aren’t transmittable, but they can become active at any time. It’s estimated that around one-third of the world’s population is latently infected.

This affects us not just here at home in the U.S. — with 9,557 cases reported in 2015 — but overseas; more than 95 percent of TB deaths occur in developing countries. If left untreated, it’s fatal in around 70 percent of cases. All in all, TB claims almost 5,000 lives per day.

But here’s the good news: TB is both curable and preventable. Even better: the U.S., along with many partner organizations, is making progress towards ending TB once and for all. Over the past 15 years, American efforts to reach those with TB, cure them, and prevent new infections have helped save 49 million lives. And since 1990, the global community has reduced the number of deaths from TB by 45 percent.

The U.S. government is a leader in the global effort to fight TB, as well as in infectious diseases research. Addressing the disease is an important element of the U.S. government’s goals of improving global health and reducing poverty — saving and improving lives, reflecting American values, and ultimately protecting Americans from becoming sick at home and abroad.

To achieve these goals, the U.S. government makes strategic investments in the fight fight against tuberculosis. But no leader can succeed alone; partnerships are key in effectively addressing TB around the world. By working with Global Fund to Fight AIDS, Tuberculosis and Malaria, the U.S. is able to expand its geographic response, reaching more than 100 countries with programs to combat TB. The bulk of the funding for these initiatives comes from the domestic budgets of those partner countries, and the U.S. works closely with other governments and organizations to help ensure the funding is spent optimally.

Indonesia is one of the top five countries that currently experience widespread tuberculosis.

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This Southeast Asian nation — spread across some 17,500 islands — has had strong economic growth and political stability, but still struggles with disparity between major cities and rural areas, where access to medical services and supplies can be geographically very difficult. Indonesia also has a high number of cases of drug resistant tuberculosis, complicating treatment.

Ambiya, a 15-year-old girl from Jakarta, is just one of many cured of drug resistant TB. Starting in 2009, the Global Fund enabled this treatment to become available through Indonesia’s public health system. Here’s Ambiya’s story.

PATH is another key organization working with the U.S. agencies like the U.S. Agency for International Development (USAID) and the President’s Emergency Plan for AIDS Relief (PEPFAR) to help wipe out TB. In Kenya, a PATH-led program called AIDS, Population, and Health Integrated Assistance (known as APHIAplus Western) helped save the life a 14-year-old boy named Blaiz.

Blaiz Atambo had been sick for six months. His father, Joseph, thought it might have been malaria — another common and fatal disease in Western Kenya. Finally, he tested positive for TB.

The shy, studious young teenager “had so many questions initially,” recounts Fred Ombati, part of the team of health providers from Kijauri Sub-District Hospital that visited his school for a screening. “‘What is going to happen to me? What is going to happen to my parents? What is going to happen to my education?’”

School testing is a vital opportunity to diagnose latent tuberculosis before the disease progresses to the infectious stage. In just the first quarter of 2015, PATH’s program reached 2,476 with information about the disease and screened 352 students.

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The proactive outreach of Blaiz’s health care team, alongside work to educate his classmates and family, allowed him to attend school while he was receiving treatment. Today, he’s free of the deadly disease, and his grades — and his health — are improving “month after month,” says his father. Now, Blaiz wants to study to become a doctor, thanks in part to the work by his health care team.

Tuberculosis has been infecting humans for at least 4,000 years, according to evidence found in Egyptian mummies. And the ancient Greek physician Hippocrates wrote that “phthisis,” another name for TB, was the most common and fatal disease during his time.

Yet now — in our lifetime — the complete eradication of this infectious disease is within reach, thanks to the work of the U.S. alongside other nations and partner organizations like the Global Fund and PATH. It’s critical that we build on the successes we’ve achieved as a global community and end tuberculosis for good.