TB Or Not TB

That is the question asked of world leaders by the Stop Tuberculosis Partnership, which is requesting $31 billion over the next ten years for the Global Plan to Stop Tuberculosis. The Plan would prevent an estimated 14 million TB deaths during the decade.

To kick-off the funding drive, Bill Gates pledged to donate $600 million. "Every 15 seconds somebody dies of TB, avoidably, preventably," said UK Chancellor of the Exchequer Gordon Brown, who helped launch the Plan at the World Economic Forum in Davos, Switzerland on January 27. "I welcome the Gates Foundation’s announcement today. For far too long, world leaders have ignored the global tuberculosis epidemic, even as it causes millions of needless deaths each year," said Brown.

"The Global Plan is fundamental for Africa, where tuberculosis was declared an emergency by 46 countries in 2005," said Nigerian President Olusegun Obasanjo.

A contagious disease caused by bacteria that most often attack the lungs, tuberculosis kills about 2 million people each year. Most of the deaths are in Southeast Asia and Africa. But tuberculosis is active worldwide and is a particular problem in Eastern Europe.

Drugs in use for more than four decades can cure the disease. A childhood vaccine against tuberculosis has been available for more than 75 years.

"This is a disease with a huge impact that is completely treatable and preventable," said Dr. Peter Small, a member of the Stop TB coordinating board. "It's not that we can't do something about it, it's that we've chosen not to."

In addition to insufficient funding, the fight against TB has also been hampered in recent years by two developments. Because HIV weakens the immune system, people who have the virus that causes AIDS are much more likely to become ill with tuberculosis than those who are HIV-negative. TB is the leading cause of death among people with HIV/AIDS.

The second problem lately has been the evolution of drug resistance among many strains of the bacteria that cause tuberculosis. Some strains, called multi-drug resistant, are immune to the effects of more than one drug.

Full funding of the Plan will help achieve the Millennium Development Goal to have "halted by 2015 and begun to reverse the incidence of tuberculosis". The Plan aims to provide:

"We have a unique historic opportunity to stop tuberculosis," said Dr Marcos Espinal, Executive Secretary of the Stop Tuberculosis Partnership. "The challenge now is for people to work together in putting the plan into action, in order to stop one of the oldest and most lethal diseases known to humanity. This plan tells the world exactly what we need to do in order to defeat this global killer."

There has already been significant progress against TB over the past several years. Since 2000, estimated spending on tuberculosis control in the 22 hardest-hit countries has increased from US$800 million to US$1.2 billion; as a result, the number of patients receiving TB treatment in these countries more than doubled.

According to Stop TB, implementing the new Plan will require $56 billion over ten years—$47 billion for expanding access to treatments already available, and $9 billion for research and development of new diagnostic tools, drugs, and vaccines. The total number is $31 billion more than the amount Stop TB estimates will be spent if current funding trends continue. The investment, the group insists, would have a profound effect on the number of tuberculosis cases averted and lives saved.

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The Bottom 10 List

The immense human toll caused by conflicts in the Democratic Republic of Congo (DRC), Haiti, Chechnya, and northeast India are among the "Top Ten" Most Underreported Humanitarian Stories of 2005, according to the year-end list released today by the international humanitarian medical aid organization Doctors Without Borders/Médecins Sans Frontières (MSF). The eighth annual list also highlights the lack of media attention paid to the plight of people trapped by chronic wars in Colombia, northern Uganda, and Ivory Coast, unrelenting crises in Somalia and southern Sudan, as well as the utter lack of research and development devoted to new HIV/AIDS tools adapted for impoverished settings.

"Media coverage can have a positive impact on relief efforts — just look at the nutritional crisis in Niger last year," said Nicolas de Torrente, Executive Director of MSF in the United States. "Although relief was far too late for many, the only reason aid efforts increased at all was the media attention at the peak of the crisis."

According to Andrew Tyndall, publisher of the online media-tracking journal The Tyndall Report, the 10 stories highlighted by MSF accounted for just 8 minutes of the 14,529 minutes on the three major U.S. television networks' nightly newscasts for 2005. Natural disasters like the south Asia tsunami and the war in Iraq dominated international reporting. But in a year that Tyndall said had an unusually high amount of international coverage, only 6 minutes were devoted to DR Congo and 2 minutes to Chechnya. The remaining stories highlighted by MSF were not covered at all. The AIDS crisis received 14 minutes of coverage, none of which, however, was devoted to the lack of R&D.

"AIDS coverage never touches upon the near-total lack of research and development into tools specifically adapted for patients most affected by AIDS," de Torrente said. "One example is the fact that there are no pediatric versions of easy-to-take antiretroviral (ARV) combinations like those that exist for adults. Without research and development into such medicines, hundreds of thousands of children will continue to die needlessly every year."

Even though there was a general increase in international reporting, insecurity in war zones again contributed to preventing journalists from reporting on some of the world's most dangerous regions.

"People all over the U.S. tell us how much they want to show solidarity and do more to help others in crisis around the world. But how can they when a crisis is virtually invisible?" de Torrente said. "Millions of people are struggling through crises in places that rarely, if ever, get mentioned in the U.S. news, and in our experience, silence is the best ally of injustice."

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Sri Lanka Peace Talks

This month in Geneva, Sri Lanka and Tamil Tiger rebels will hold their first talks in three years. Violence has shaken the truce in Sri Lanka's decades-long civil war.

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