Smarter budgeting and easing regulatory restrictions may aid in newest phase of public health battle against infectious disease.
Last year, I noted that once vanquished diseases were emerging across America, in part because of the steady stream of infected immigrants crossing the border.
These included the tuberculosis, the historic killer that once once responsive to the antibiotics our medical professionals prepared. However, the influx of refugees with resistant strains of this pathogen is now threatening the quality of our nation’s health.
The rise of drug-resistant tuberculosis (TB) threatens to derail decades of progress in the fight against the disease, experts warn in a new report published in The Lancet Respiratory Medicine.
TB kills more people worldwide every year than any other infectious disease, including HIV/AIDS. In 2015 alone, researchers estimate TB killed 1.8 million people.
Tuberculosis is caused by a bacteria that can be spread through the air when an infected person speaks or coughs. It usually attacks the lungs, though the CDC notes it can damage other vital organs as well.
About 1 in 5 TB cases are now resistant to at least one major drug used to treat the disease, the authors report. Approximately 5 percent of all cases are resistant two essential first-line TB drugs — referred to as multi-resistant — or extensively drug-resistant, meaning they are resistant to even more treatments.
…The TB epidemic now is “at a crossroads,” Dr. David W. Dowdy, of Johns Hopkins Bloomberg School of Public Health, wrote in In an accompanying editorial.
“Over the next decade, it is quite possible that we will see a drug-resistant tuberculosis epidemic of unprecedented global scale,” he writes.
Multi-resistant TB has a 40 percent death rate, and it is 60% for the extensively drug-resistant version.
As public health officials now become aware that the real alarm infectious disease experts were sounding over the past years has been real, they are now chiding the White House for proposed budget cuts.
Michael T. Osterholm is an epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, and Mark Olshaker is a documentary filmmaker who co-authored the book with Osterholm entitled Deadliest Enemy: Our War Against Killer Germs. They penned a warning in The New York Times:
While the Trump administration is proposing significantly increased military spending to enhance our national security, it seems to have lost sight of the greatest national security threat of all: our fight against infectious disease.
…President Trump’s budget would cut funding for the National Institutes of Health by 18 percent. It would cut the State Department and the United States Agency for International Development, a key vehicle for preventing and responding to outbreaks before they reach our shores, by 28 percent. And the repeal of the Affordable Care Act would kill the billion-dollar Prevention and Public Health Fund, which provides funding for the Centers for Disease Control and Prevention to fight outbreaks of infectious disease. (While the budget also calls for the creation of an emergency fund to respond to outbreaks, there is no indication that it would offset the other cuts, or where the money would come from.)
However, President Trump has always been a proponent of getting better quality for less cost. This is likely to apply to bloated bureaucracies that have deviated from their original mission significantly. Professor Glenn Reynolds reminds us of the 2014 budget, following the CDC’s disastrous response to the Ebola crisis, showing that the focus has been more on virtue signaling rather than disease control and prevention.
* Chronic disease prevention (obesity, heart disease, etc): fiscal 2014 budget approximately $1 billion, or just under 15% of the total budget.
* Birth defects: $132 million, or just about 2% of the total budget.
* Environmental health (asthma, safe water, etc): $179 million, 2.6% of total.
* Injury prevention (domestic violence, brain injury, etc): $150 million, 2.2% of total.
* Public health services (statistics, surveillance, etc): $482 million, 7% of total.
* Occupational safety (mostly research): $332 million, 5% of total.
Trump’s administration has also begun sweeping away innovation crushing regulatory burdens that have hampered vaccine development, an important weapon in the arsenal against disease. The House of Representatives has recently reinstated of a procedure called the Holman Rule, which empowers any member of Congress to propose an amendment to appropriations bills that would single out a government employee for salary reduction or cut a specific program. Bureaucrats who unnecessarily delay approval of an important new product or project (such as a life-saving drug or vaccine) could be sanctioned.
Alarmists have alarmed for so long that they have lost sight of where the real hazards lay. Smart review of budgets and an easing of unnecessary regulatory challenges will help us deal with national security threats, like drug resistant TB, more effectively.