U.S. must be a leader in attacking global spread of tuberculosis

Tue, Mar. 28, 2006

SEN. BOXER DESERVES SUPPORT IN EFFORT TO BATTLE A SCOURGE OF THE DEVELOPING WORLD

Mercury News Editorial

The vast majority of Americans probably cannot name the disease that kills more people than any other curable disease in the world and infects a third of the global population.

California has more cases (2,900 in 2005) of the disease than any other state in the nation, and San Jose's case rate is among the top 20 in the nation.

The disease is tuberculosis, which is caused by a form of bacteria that usually attacks the lungs. TB is transmitted through the air when a person with the disease coughs or sneezes.

As the world marks the 100th anniversary of the discovery of the bacteria causing TB, tremendous challenges remain in ending an epidemic that kills 5,000 people every day. Congress should pass the legislation being introduced this week by Sen. Barbara Boxer, D-Calif., that will provide a minimum of $225 million in 2007 aimed at cutting the disease's global death rate in half by 2015.

Immigrants account for 95 percent of Santa Clara County's TB cases and 85 percent of Alameda County cases, according to Dr. Robert Benjamin, medical director of the Alameda County TB Control Program. Many arrive here from the developing world, where the TB epidemic is centered. Benjamin points out that most immigrants are not screened for TB before arriving in the United States.

The nation should improve its screening and diagnostic techniques for immigrants to reduce the number of U.S. cases. And it should do its part to fulfill the moral obligation of trying to rid the world of one of its worst killers. Slowing the spread of tuberculosis around the world will not only reduce the number of cases in the United States, but it will also help slow the devastating impact of the disease in places such as Africa and Eastern Europe.

The number of cases reported in the nation has actually dropped in recent years, which explains in part why President Bush's budget calls for a $250 million cut to the effort to fight TB, AIDS and malaria. But the United States, thinking it had its TB problem under control, tried trimming its budget to fight the disease once before, in the 1980s. The surge in the number of reported cases in the 1990s proves the dangers of that approach.

``There are so many problems in the world that you throw up your hands because you don't know what to do,'' says Boxer. ``This one we clearly know what to do. . . . Shame on Congress if we can't step up and do our share.''

Tuberculosis, which infects an estimated 2 billion people, is curable, although drug-resistant strains are making the task more difficult. The United States should act on Boxer's inspiration and do its part to fight the spread of tuberculosis at home and abroad.