New leadership needed in tuberculosis fight
By Adam Smith and John C. Lechleiter

Special to The Times

WHEN scientists created the first antibiotics to cure tuberculosis (TB) in 1952, the world believed this scourge soon would be weakened or even eliminated. But triumph and hope turned to complacency based on the myth that TB was yesterday's disease or limited to isolated parts of the world. In fact, since the discovery of a cure, more than 120 million people have died from TB, with another 1.7 million deaths expected worldwide this year alone.

The complacency must end. TB is now spreading rapidly throughout the globe, and it is mutating into something more deadly than ever before. Joint efforts by governments and the private sector can give us back the upper hand against TB — and bring down its devastating toll.

TB cuts people down in the prime of their working lives, robbing the world of an estimated $12 billion in income every year. World Bank experts estimate loss of productivity to be almost 7 percent of some countries' entire gross domestic product. In this way, the disease helps to perpetuate poverty, as the crowded living conditions of many of the world's poor increase the risk of contagious TB infection even further. It's a vicious cycle.

The World Health Organization estimates that each person with TB infects up to 15 other people, usually by the simple act of coughing the germs into the air. In today's interconnected world, TB no longer can be contained in one area or region.

The TB bacteria is also not standing still. Incomplete or inconsistent treatment of TB breeds drug resistance. The variant called multidrug-resistant tuberculosis (MDR-TB) does not respond to first-line drugs, costs much more to treat and is spreading globally.
Worse yet, extremely drug-resistant tuberculosis resists nearly all drug treatment and has a death rate of 85 percent. Several cases of the extremely resistant strain already exist in Europe and the United States. The U.S. Department of Homeland Security identifies the mutated disease as an "emerging threat to the homeland."

No single government or private organization can fight such a threat alone. An effective response will require strong public-private partnerships throughout the world.

President Barack Obama has been vocal about building on the work of previous administrations in fighting infectious diseases. Together with agencies such as the Centers for Disease Control, Agency for International Development and the private sector, Congress should craft and implement a plan to meet TB treatment and detection targets — and to develop more-effective drugs, diagnostics and vaccines.

Last year, Congress took a large step in addressing TB worldwide by passing the Lantos-Hyde Act, which authorizes updates to U.S. policy and a significant funding increase to fight TB. This includes the target of treating 4.5 million people globally who are infected. But much more needs to be done. The Lantos-Hyde Act calls for the development and congressional oversight of a five-year global TB strategy — and we should ensure this is a priority.

Partnerships work in the fight against TB. One good example of government and private entities working together is the partnership forged by Eli Lilly over the past six years to support a comprehensive strategy against the multidrug-resistant strain. The partnership, backed by $135 million from Lilly, supports patient advocacy, implements treatment and training programs in hot spots of this strain around the world, and transfers drug-manufacturing technology to countries hardest hit by the disease.

In Seattle, meanwhile, the new TB Drug Discovery Initiative links Lilly with the National Institutes of Health, the Infectious Disease Research Institute and several other groups to spur research into new drug treatments. We will never defeat TB without simpler, faster drug regimens that treat all forms of the disease. And we need to move products through the development pipeline and into the field more quickly.

U.S. leadership can make a profound difference in battling this epidemic. Today is World TB Day, but our resolve needs to be just as strong tomorrow and in all the days ahead.

Congressman Adam Smith, D-Tacoma, represents Washington's 9th Congressional District. John C. Lechleiter is chairman and chief executive officer of Eli Lilly and Company.