Clyburn (SC06) - Statement - Ending Tuberculosis Should be a Political Priority

A popular saying claims that each of us is connected to everyone else in the world by a mere “six degrees of separation.” Whether it is six degrees or sixty, there is no doubt that in our global health we share a common fate. Tuberculosis is a good example. TB will kill nearly 2 million people this year, more than ever before. Approximately one-third of the world’s population is infected with the bacteria that cause TB -- over 2 billion people.

In recognition of World TB Day on March 24, I am compelled to question why TB remains a major public health problem more than 40 years after drugs for curing the disease were discovered. Perhaps it is because the groups most affected by TB -- the poor, racial minorities, those with HIV/AIDS, and those in developing countries, especially sub-Saharan Africa -- do not possess the political and economic power to eradicate the disease.

Here in the United States, TB disproportionately affects minorities: African-Americans suffer from the disease at a rate eight times greater than that of Caucasians. South Carolina ranked 9th in a 1999 national, state-by-state comparison of tuberculosis case rates, while ranking 26th in population. In 2000, there were 146 cases in the sixteen counties that comprise the Sixth Congressional District I represent, that is more than half the TB cases statewide. Each untreated case can infect 10 to 15 other people per year.

Overseas, sub-Saharan Africa has the world’s highest rates of TB infection and disease, with the number of cases quadrupling since 1990, mainly because of HIV. TB is the leading cause of death among people who are HIV positive. In 1997, almost half of the nearly 31 million HIV-positive people worldwide were also infected with TB.

Whether at home or abroad, TB knows no borders. It can be passed through coughing or sneezing. In our era of jet travel and international trade, it is not possible to eliminate TB in this this country if it is allowed to spread unchecked in other parts of the world.

There is hope. A cheap and effective cure for tuberculosis does exist costing just $20-100 per person and resulting in a 95% cure rate. It can quickly render individuals with TB non-infectious, and reduce further spread of TB infection in regions where HIV is rampant.

Controlling tuberculosis is within our power, but we must commit to making it an immediate and continuing political priority. There is an urgency in these efforts, because the drugs used to treat TB are slowly being rendered useless as drug-resistant strains of the disease develop. Up to 50 million people in the world already may be infected with drug resistant tuberculosis, and it is extremely expensive to treat. One case can cost as much as $250,000 in the U.S. compared to only $2,000 for non-drug resistant TB.

That is why I am supporting Congressional efforts to invest $200 million in international TB control this year. According to TB experts, $1 billion in additional funding is needed to adequately address this killer. $200 million is a reasonable U.S. share of that amount, and a wise investment in protecting the future of our global society.

Today your family may not be directly touched by TB. But who is to say when that six degrees of separation will catch up to you if we allow this deadly disease to go unchecked. We must not let lack of access to traditional channels of power keep those most in need of treatment from receiving it. We must commit now to making the global control of tuberculosis a political priority, and begin by dedicating $200 million to TB control abroad.