President Obama working on an Action Plan to stop drug-resistant TB

The letter urges the President to develop a comprehensive and ambitious plan and to propose the necessary funding required for agencies to implement the plan, beginning in FY 2017.

The President is personally concerned about the threat of antibiotic resistant bacteria, raising it in his State of the Union Address at the beginning of the year. He has already issued a bold plan on antimicrobial resistance, and this new plan on TB specifically is slated for publication in September.

After several years of budget proposals by the President that single out USAID’s Tuberculosis program for drastic cuts, it’s very encouraging to see this change in direction.  USAID plays a crucial role in building capacity and self-reliance in countries struggling with TB epidemics, so we have opposed funding cuts and argued instead for an increase, while also building support in Congress.

By September 1, USAID Acting Administrator Alfonso Lenhardt will submit his budget proposal to the Office of Management and Budget for review, and we hope it contains the funding increase the agency needs to implement its part of the Action Plan.

The stakes are high. TB impacts women and it preys disproportionately on expectant mothers, increasing the rate of miscarriages and the risk of death for both the mother and her baby.  Scientists know little about the safety and efficacy of the few available MDR TB treatments during pregnancy. Tragically, it is the children in the families of people with TB who often go on to develop the most serious forms of the disease. TB is also a major risk to health care personnel and sometimes it kills them.  

The White House recently convened a Stakeholder Dialogue to gain input on the Action Plan, in which Joanne Carter, Executive Director of RESULTS, and Ambassador Eric Goosby, UN Special Envoy on TB, were featured speakers. The meeting was led by Susan Coller-Monarez of the White House Office of Science and Technology Policy. She stated:

"What I find alarming is that 4000 people a day die of TB and the rate of the acceleration of drug resistance will take this from a daily tragedy to potentially a catastrophe. So, this Action Plan needs to be a commitment that we are dedicated to preventing this tragedy from becoming a catastrophe. I cannot emphasize enough that plans are just “words on a page.”  So, once we have the plan we have to act on it."

She added that the agencies she has pulled together have been meeting regularly and that she has been impressed at the “level of passion and commitment to working together.”

The Action Plan presented at the meeting included some bold targets to increase access to MDR TB treatment, including a plan to initiate 50 percent of MDR-TB patients on treatment in the 10 highest burden countries by 2020.

Joanne Carter noted at the meeting that the conditions are right for an ambitious plan, to support prevention of drug resistant TB, treatment of all forms of the disease, and urgently needed research into vaccines, diagnostics and faster-acting treatments. 

The Action Plan also aims to address the weaknesses in the US domestic response. In the US there are about 100 active cases of multi drug resistant TB a year, and the CDC has documented that over a two to three year period this leads to more than 1000 exposures and more than 300 infections with MDR TB. So, the letter sent to the President this week also stresses that a bold plan is needed in order to protect people in the US and meet the needs of vulnerable communities.

President Obama is poised to lead the world to finally end TB. Now we await the full plan -- and the financing -- to make this extraordinary vision a reality.

Source: RESULTS