THE WHITE HOUSE and the Democratic-led US House reached a budget agreement this week to spend $50 billion over five years to combat HIV/AIDS, tuberculosis, and malaria. That's good news. The not-so good news is that the World Health Organization is raising an alarm about strains of TB that are resistant to some of medicine's most potent drugs.
Now that the House Foreign Relations Committee has endorsed the $50 billion commitment, the full House and Senate should approve it to maintain US leadership against these three infectious killers. The effort can help save millions of lives in impoverished countries around the world.
In much of the developing world, TB and AIDS are a lethal one-two punch. In the weakened immune systems of AIDS patients, latent TB can become a full-blown and highly contagious infection.
Health workers can treat most TB patients, but increasingly they are coming up against strains that resist the frontline TB drugs. Since incomplete or inadequate drug treatment of TB breeds such dangerous strains, the most effective way to keep them from developing is through a full course of closely supervised treatment of all TB patients.
This is why it is so crucial that the $50 billion AIDS package is not limited to that disease. Fully $9 billion of the $50 billion would go toward bilateral programs to deal with TB and malaria, and $4 billion would go to the United Nations' Global Fund to Fight AIDS, TB, and Malaria. The package also loosens a previous congressional mandate by reducing the share of all HIV-prevention funding that must go to abstinence programs. Health workers have rightly complained that the mandate sometimes limits the best use of US money, including the purchase of drugs to stop mother-to-infant transmission of the virus.
The global need for more drugs is intense. The WHO reported this week that in regions of the former Soviet Union, multidrug-resistant forms of TB make up as many as 22 percent of all new TB cases. Health experts believe this reflects a breakdown in public health systems after the collapse of the Soviet Union. Globally, about 5 percent of all new TB cases are resistant to two or more drugs. Curing a TB patient can cost as little as $20 if the infection responds to drugs and as much as $1,500 to $15,000 if the bacteria are not responsive to the mainline drugs.
The $50 billion commitment is more than triple the first $15 billion Bush pledged in his 2003 State of the Union address. But the need has grown in the last five years as international health organizations try to make AIDS drugs available to all who need them and to treat TB and malaria. Congress should act quickly to leave no doubt that, even in the midst of two costly wars, the United States can still lead the world's samaritans.
